It Turns Out ‘Eating Right’ Isn’t Complicated
There are no magic foods. Cleanses are unnecessary and probably unhealthy. But we're still eating a diet high in crap we know we shouldn't eat.
Mark Bittman and David L. Katz have what they purport to be “The Last Conversation You’ll Ever Need to Have About Eating Right.” It’s certainly long enough. The key takeaways, alas, are that there are no magical foods and no secret diet that really works. On the other hand, you don’t need to do juice cleanses, fasting, and other weird practices, either.
So what can I eat?
This is a good place to start because the real experts in Stone Age nutrition think our ancestors — who, by the way, were foragers — consumed a wide variety of ever-changing plant foods that gave them up to 100 grams of fiber daily. We, on the other hand, eat an average of 15 grams of daily fiber. Our forebears are thought to have eaten lots of insects, too. (Few people espousing the virtues of “Paleo” seem inclined to try that out.) They probably ate grains, with some evidence they did so 100,000 years or more ago. And, of course, they ate the meat of only wild animals, since there were no domesticated animals in the Stone Age, with the possible exception of the wolf-to-dog transition.
In any event, the diet to which we are adapted is almost certainly much better for health, and reversing illness, than the prevailing modern diet. There is abundant evidence of disease-reversal with diets of whole, minimally processed food; plant-predominant diets; and even plant-exclusive diets.
If there’s one thing I know for sure, it’s that carbs are evil.
This is probably the silliest of all the silly, pop-culture propaganda about diet and health. All plant foods are carbohydrate sources.
Yeah, but: Carbs are evil.
Everything from lentils to lollipops, pinto beans to jelly beans, tree nuts to doughnuts, is a carbohydrate source. Most plant foods are mostly carbohydrate. So if “all carbs” are evil, then so are vegetables, fruits, whole grains, beans, lentils, nuts, and seeds.
Sure, but, I should still avoid carbs, right?
Exactly the opposite is true. You cannot have a complete or healthful diet without carbohydrate sources.
What about gluten? It seems like everyone is kind of gluten-intolerant now.
On the contrary: Statistically, a small percentage of the population is gluten intolerant. About one percent of people have celiac disease, and perhaps 10 percent have lesser forms of sensitivity, which may be related to other factors, like a disrupted microbiome. But still, 90 percent of people have no problem digesting gluten.
I want to lose weight. Is diet really more important than exercise?
Yes. It is much easier to outeat running than to outrun all of the tempting calories that modern marketing encourages us to cram in. Both diet and exercise are important to health, and exercise is important in weight maintenance. But to loseweight, the preferential focus needs to be on controlling calories in, more than calories out.
Wine! I’ve heard moderate alcohol consumption is good.
Alcohol is the quintessential double-edged sword: There’s a chance for some benefit, but there are risks as well. There’s the relaxation factor, which is immeasurable, and the consensus, which is pretty clear, is that “moderate” consumption may be beneficial and, even more likely, isn’t harmful. “Moderate” means two glasses per day for men; one for women. (Men have higher levels of alcohol dehydrogenase than women, and thus metabolize alcohol more efficiently than women.) There is an association of almost any level of alcohol intake with increased cancer risk, including breast cancer in women and of course liver cancer.
So what is the healthiest alcohol? Is tequila as clean as the hype? Should I aim for low carbs or low calories?
If you think you are drinking alcohol for health, stop now. If you’re drinking it for pleasure, keep your intake moderate and don’t worry about the form, as long as it’s not — for example — paint thinner. If your question is about calories, spirits are the most efficient alcohol in terms of bang for buck; beer is the least. Of course if you take your spirits with ginger ale, it’s a different story.
What about the theory that red wine is good for you?
The antioxidants from the skins of grapes may confer unique health benefits, which would suggest red wine is the best form of alcohol. Again, don’t drink because you think it’s the healthy thing to do.
What about coffee? Please don’t take away my coffee! Caffeine has positive effects, right?
Positive and negative.
What are the positive effects?
Positive: alertness, slightly enhanced cognition.
I’m going to regret asking this but — what are the negative effects?
Negative: potential increases in heart rate, blood pressure, jitteriness, and insomnia.
The problem, of course, that most of us know most of this and aren’t doing it because either we enjoy processed foods more than veggies or because it’s easier to grab something quick and tasty than to shop for and prepare healthy foods. I can’t imagine reading OTB who thinks half a pepperoni and sausage pizza downed with three IPAs are a healthier option than a spinach salad topped with salmon along with a big glass of water. But, in the moment, the former is certainly more appealing. Similarly, I don’t know many people who think having that third scotch is helping ward off cancer.
To that I would add a couple of things. One size does not fit all. Two different people can eat precisely the same amount of precisely the same things and get the same amount and kind of exercise. One might be fat and one might be thin. Is it because of difference in their microbiomes, genetics, who knows?
Another is that in every environment going as far back as we can find evidence human beings have preferentially sought out the food source with the greatest amount of fat. Whether that’s good for us or not depends on circumstances. In other words our evolutionary history can fool us into behaviors that are counter-productive to our health in the circumstances that prevail now.
And that history varies. People of European descent tend to be able to tolerate dairy better than people of sub-Saharan African descent and alcohol better than people of East Asian descent. Those are adaptations and they vary from population to population.
Pretty interesting. I somewhat disagree about the exercise and weight loss – it depends upon the individual, and ironically enough, how fit they are. Unfit people can’t exercise off weight; already fit people can and typically do.
Extreme examples of this are high level athletes (Olympic level cross country skiers for example reportedly burn off 7000-8000 calories to day, and have to eat so much they find it a chore, to the point where their coaches are often concerned that they’re not eating enough). Even for us normal types, a couple of hours of activity (even a brisk walk) a day for a month is more than enough to burn off the five pounds you might put on over Christmas. I end up doing this every January, Christmas eating is hard to avoid and I’m not disciplined enough to alter my diet, so I just throw in an extra hour or so of walking every evening and the weight disappears by February. (I should probably continue to do the extra walk year round, but somehow never do).
The problem is for people who are 100 pounds overweight and in poor physical condition; they haven’t the endurance to (safely) exercise long enough to make progress. For them eating less is the only reasonable option.
Paleo diets amuse me. There seems to be an assumption that our ancestors had these amazing diets rather than eating whatever was available. And I’m not sure we have a lot to learn from a group of humans who maybe lived to be 40. Furthermore, we’ve evolved a bit since then and our dietary needs may be different (e.g., dairy is not tolerated by most adults; it’s a recent mutation that’s way more prevalent in white people than non-white). I’m overweight and there’s no magical reason why: I eat too much, period.
I *do* however, wonder about the role of gut bacteria. I was recently talking to a pediatrician who said he’s trying to cut back on antibiotics because there is some literature indicating a connection between obesity and pediatric antibiotic use (like most things in medical research, it’s tentative at best). I do wonder if we’re killing off some gut bacteria that would help with obesity. I would not be surprised at all if, twenty years from now, fecal transplants are used as a treatment for obesity. Well, I’m sure they will be anyway. But I would not be surprised if there is some actual science behind it.
There foods that can help reduce bad cholesterol and keep arteries open. I avoid beef because of gout. Water keeps the kidneys clear. Cholesterol problems can be inherited and medication is usually necessary, even if a person is a world class runner or a SEAL.
A calorie is a calorie. I’ve lost 28 pounds in the last 4 months and one of my diet tricks is ordering Cadbury’s chocolate from the UK, violating the Hershey’s ban on chocolate that actually tastes like chocolate coming into America. I can eat 250 calories of Cadbury’s, or I can eat 250 calories of eggplant and tofu. Guess which one fills me with anticipation? If you do not retain a strong element of pleasure in your eating, you won’t stick to whatever diet. We are meant to take pleasure from food. Our brains won’t stop nagging us until we give it some joy, and in the end, that insistent demand will win out over kale.
Also, whiskey runs 70 or 80 calories an ounce, while marijuana is calorie-free.
So, yes, I’m telling you that on a diet of Cadbury Dairy Milk bars and Jack Herer, and following an exercise regimen I like to call Total Immobility, I’m already lighter than I’ve been at any time since I stopped waiting tables, and with a bit of luck I may get down to where I was when I was sleeping under bridges. And then I will have eternal life! Yay!
@michael reynolds: Congrats on the weight lose, but… Cadbury’s?! Give a shout the next time you are in either Paris or Brussels and I’ll hook you up with some great addresses.
As far as short-term “tactical” diets are concerned, I think you are absolutely correct about a calorie being a calorie. For those needing to wage longer-term campaigns, a more balanced diet is necessary.
For some reason, despite (typically) gross and visible evidence to the contrary, we all feel ourselves to be experts in matters of diet and health. Myself included!
Most diets in America seem to have one primary purpose … to sell books, supplements or some other sort of money making vehicle. The basic rule is, if you can’t imagine yourself eating that way for pretty much the rest of your life, then no matter how much weight you loose on your latest fad diet, it’s almost guaranteed to be unsuccessful over the long-term.
As I was reading the quip about carbs in the article above, I couldn’t help recalling this clip from Hulu show Casual: https://twitter.com/hulu/status/738067328282165252
Cracks me up every time. 🙂
@michael reynolds: Actually, I do like both tofu and eggplant, but it may be partially related to having lived in Korea for 8 years and eating a fair amount of both while living there (not to mention the extra eggplant at Halal restaurants in Seoul). But I do see your point about Cadbury’s also.
Re Cadbury’s: Your provisioning chain in Bay Area grocery stores must be broken. I can buy Cadbury chocolate in my local Winco Warehouse Store as well as other retailers. Personally, I like Trader Joe’s better, but I’m not a Dairy Milk guy either. 70%+ dark is the bomb. Still, Dairy Milk is better than either Hershey’s or Nestle’s.
Ah, I see you don’t understand my psychology of chocolate. Cadbury’s is a B+. Very good, but not as good as, say, Recchuti, a company here in SF that makes ridiculously great chocolate. They make A+ chocolate. I can control B+, but I do not trust myself with A+.
The battle is won or lost at the supermarket. If you’re a meth addict, don’t have meth in the house. I buy the best ice cream I can find because it’s self-limiting for me. But a five berry pie? No, I’m eating that. The entire pie.
The paleo diet would work great if people actually ate like paleolithic peoples. Wake up in the morning, grab a rock and a stick, and go out to find something to eat. Don’t find anything, go hungry. You get meat if you kill something or find some carrion that is reasonably fresh. If you add in being chased by wolves for your cardio, it will help. Want something sweet? Challenge a bear (Ursus arctos) for a shot at a beehive.
@Hal_10000: My daughter’s PhD dissertation dealt with gut bacteria, and she tells me bacteria of phylum Firmicutes can metabolize certain fiber into short-chain fatty acids that humans can then metabolize as an energy source. An overabundance of Firmicutes can produce SCFAs that account for 6-10% of basal energy requirements for a human.
So basically the unfortunate person ends up 10% “in the hole” when trying to lose weight by eating less. It’s just unfair.
Fortunately, by changing to a lower-fat diet one can decrease the prevalence of Firmicutes and increase bacteria of phylum Bacteroidetes, which don’t have this “energy harvesting” effect.
If you just go to teh Google and put in “firmicutes and bacteroidetes” you will find a lot of scholarly articles on the potential effect of differing proportions of gut flora on bodyweight. It’s fascinating, really.
A few years ago, I went in for my semi-annual dental cleaning and check-up. When she was done with the examination, my dentist said, “You have a very healthy diet.” I laughed and said, “How can you tell?” She replied, “By looking at your teeth.”
Of course there’s the argument (at least according to a friend who’s a professor of paleobiology) that the Paleolithic era lasted 2.6 millions years, during which humanity spread over much of the world, encountering different food sources both over time and space. That is, there was no single Paleolithic diet. What’s called the Paleo diet is an example of one type of Paleolithic diet; there apparently were many others.
Personally, I wonder if the historical Paleolithic secret is walking, which apparently every human group did a lot of back then. As well, I know quite a few people who walked off excess weight without any diet change – a slow process, about 1/2 a week I’m told, but one which keeps the weight off for decades (until your body breaks down to the point where walking becomes impossible) and takes minimal discipline compared to dieting (ie walk a lot).
That’s interesting, but there are also large numbers of people who lose and keep off considerable amounts of weight with keto diets (ie diets with a lot of fat). Its hard not to think that different people have different optimal diets, because its apparent that different things work for different people. Optimal diet seems to be like favorite music or books; what is enthusiastically recommended by one person often doesn’t work for another, who finds a different (often diametrically opposed) solution that works for them (and typically tries to get everyone else to use it).
Which is another advantage for exercise (my own personal hobby horse in this race); everyone seems to agree that exercise works if you do it; the problem with exercise, even among those who say it doesn’t work, is not in the exercise itself, but in that people simply won’t do much of it.
@george: The problem with “keto” and other diets that severely restrict some component of food is they don’t result in long-term weight loss because they are so difficult to stick to.
Eating less and exercising works, but people don’t want to put in the effort, so they go on these faddish, severely carbohydrate-restricted diets, which are high in fatty, processed, high-sodium foods, and yes, they lose a bunch of weight quickly. But after a while they start eating like they used to, and most of the weight comes back, which is “yo-yo dieting.” That’s worse for them than if they had done nothing at all.
I’ve heard that, but I think the appropriate saying for dieting is “your mileage will vary”. I know several guys who’ve been eating keto for many years (from long before it was popular) and who are remarkably fit (possibly because they do crossfit) and slim (possibly also from crossfit, though they claim their diet gives them the energy to work out rigorously.
Its like the reports that its almost impossible to lose weight and keep it off. Yet there is a website full of people (over 5000 in the National Weight Control Registry) of people who lost weight and kept it off for over five years, and apparently many for decades.
In engineering having 5000 counter-examples automatically throws out “impossible”; in fact, having even a single counter-example eliminates impossible. But the terms are thrown around loosely in dieting; if the majority have trouble with something its assumed everyone will, even when there are thousands of counter-examples.
I really think (as a non-biologist) that biological systems are way too complex for that; keto clearly works for some people. Paleo clearly works for some people. Eating less and exercising more clearly works for some people. Apparently the Cadbury diet works for at least one person. So that makes it simply wrong to say that the keto diet (or many other diets) don’t result in long term weight loss; what should be said is that for many people the keto diet doesn’t result in long term weight loss. The gap between “many” or even “most”, and “all” is huge.
I have to admit I don’t understand why the nutrition world is so hung up on universals – ie something either works for everyone or doesn’t work for everyone, given how demonstrably false most such claims are. The study for instance which was oft reported (ie that its impossible to lose weight by exercise alone) had 5% exceptions even within its own data – if I tried to publish a physics paper saying something was “impossible” which had 5% success rate (about 2 standard deviations) it would not only be rejected, but they’d probably never look at anything else I ever sent them. Yet this happens all the time. Some people do lose and maintain weight loss from Keto. Its a simple fact. How common it is is another question; but that simply means people have to try various things for themselves until underlying reasons are discovered (think blood types, and how it worked sometimes and not other times until we understood what was going on).
Myself, I find the Keto diet pretty dull, I would never use it. For me its exercise more all the way, which has served me fine for more decades than I care to admit, despite the reports saying its impossible.
@Hal_10000: Actually a real Paleo-type diet would incorporate with the gut bacteria thing you talk about. I wish I could find the link I had to some story about some modern hunter-foragers (wish I could even remember their name right now). But if you dig stuff out of the ground or catch wild animals and eat their organs (sometimes not even cooked), you’re dousing your intestines with all kinds of bugs. And these people are nonetheless pretty healthy.
Anecdotally, my least healthy kid (of three) by far is the one who had a series of ear infections when he was young. He went through multiple rounds of antibiotics. He’s now allergic to a bunch of stuff (including nuts) and has eczema and asthma. My other kids are fine. In fact I delayed filling a prescription for antibiotics for one of them because I didn’t think her ear infection was really that serious. And it went away on its own, luckily.