What should I eat? Nutrition 101 with Dr. B.
I often get asked, "what's the best diet? what should I be eating?"
The short answer is... it depends.
I believe the truest answer requires assessing your individual needs with a one-on-one consultation determining your current health concerns, specific nutrient deficiency, susceptibility to disease (family history/genetics), food sensitivities/allergies/intolerances, and level of activity. What "diet" may work for some, may not be beneficial to others.
What I will say, is there are some nutrition basics that are pretty consistent across the board and often this is where I start with all of my patients.
First of all, I never use the word "diet". While academically diet just means the food a culture habitually eats, our modern day perception is that diet = depriving oneself and often "immediate results".
I will only use the word "nutrition" and abide by my care's motto "lasting sustainable change" with all of my treatments. I want you to eat for health. I want you to evolve your nutrition into a lifestyle, even if that means small incremental changes to make it happen. I believe the difference is diet=restriction and nutrition= abundance & vitality. I will focus on nutrient-dense food that feels good in your body, rather than focusing on what you shouldn't be eating. I like to increase the good, to crowd out what's not as beneficial.
My goal is to create a healthy relationship between you and your food. I avoid using words like "bad" or "harmful" foods, because we should be using foods in a constructive way-- a nourishing, supportive relationship-- rather than one built on on fear, guilt, and shame. I also don't use the word "cheat" for that reason. Cheating instils a level of guilt and "wrongness" into your actions. How I approach this is having my patients adopt a 80-20 rule-- be consistent and focus on your nutrition 80% of the time, the other 20% are treats, foods that are less beneficial but that you enjoy as a sometimes thing. No fuss, treat yo'self.
Sometimes this means compromise. For example if I'm dining out, I'll opt for either an alcoholic drink or dessert, not both.
I am a huge fan of Michael Pollan's work. With his anthropological research on nutrition, he wrote a book called In Defense of Food, that outlines three guidelines. (Read my book review here)
Not too much.
Boom. It doesn't get much simpler than that.
Well... simple in theory, but one of the hardest lifestyle changes to make.
When I was a fourth year medical student, I sat in on a patient consult with a naturopathic doctor. The ND suggested to the patient she would benefit from the "Whole 30 Diet". When the woman asked what the diet was, the doctor replied that it basically involves eating whole foods for 30 days. "That sounds really expensive... I don't know if I can shop at Whole Foods for a whole month".
Trying to be a silent observer in the corner, I shoved down a snort, but the doctor and I couldn't help but laugh... "no, no.... eating real food for 30 days".
One of the first steps is getting my patients to emphasize whole foods and crowding out fast, processed, and packaged foods. These are nutrient-deplete, full of preservatives and inflammatory fats and sugar, and contain artificial ingredients that your great-grandmother, and your body, wouldn't recognize as food. If the package has words you can't pronounce, put it back. Better yet, avoid buying food in a package.
One of my favourite nutrition quotes is, "If you are what you eat, don't be fake, easy or cheap."
NOT TOO MUCH
Meal quantity and frequency varies for an individual's needs, but the most important part of creating a healthy appetite is building routine with your mealtimes.
While snacking may be ideal for some, I discourage "grazing" or unnecessary snacking. Have your set mealtimes, and if you're going to snack, try and make it substantial.
(Dr. B caveat, if you're in the fourth trimester and nursing, scrap this and do whatever you can to get food and fluids in you).
Really hone both your hunger & satiety (when you're full) cues. Are not hungry, but actually thirsty? Is your energy tanking because your blood sugar has dropped? What foods are you craving?
Honing this will allow better portion control and avoidance of those infamous second-helping groans of regret.
While I'm not one that emphasizes calorie-counting, decrease unnecessary calories. Often I tell people to look at what they're drinking because it is a commonly overlooked hotspot for big ticket calories. How many calories are in that mocha-chocho-frappo-drizzle-whip-a-doodle? Alcohol is also one of the highest calories-per-unit at 7 calories/gram (protein is 4 calories/gram).
Bear in mind that calories are not the be-all-end-all of nutrition. I tell my patients to avoid "empty calories"-- foods that are high in calories with no nutritional benefit. For example healthy fats have a high caloric value but are not only nutritionally beneficial, but essential.
If you're looking for a place to start, try cutting out liquid calories-- just drinking water and plain tea for one month.
I believe an optimal diet is one that is plants-based. Note that this does NOT mean vegetarian or vegan. In fact, I know many vegetarians that aren't "plants-based"-- they just don't eat meat. Go figure.
Plants-based places a large emphasis on plants, and my recommendation, emphasizing vegetables over fruit.
A piece of advice I give my patients is "eat one green thing a day". This is easy to remember and non-restrictive. As Michael Pollan reasons, what people don't eat may matter as much as what they do.
This may seem too simple, but nutrition doesn't have to be complicated.
You don't need exotic superfoods and crazy complicated diets. We've been led to believe that because eating broccoli isn't sexy, that rockin' a salad ain't flashy. (For the record, I think eating broccoli is sexy.)Medicine is complicated, my care is clear. I'll nerd out on the science-y bits and take the nutrition guess-work out to assess and tweak ideal nutrition for YOU.
While I tend to avoid restrictive diets, in certain cases a food (or food group) elimination is necessary to fix the underlying cause. I tell patients "this isn't a forever thing" where we need to improve digestion before we throw trigger foods, or more difficult to digest foods at it.
That being said, I'm also not medically negligent and misinform my Celiac patients that gluten is a "sometimes food", when it's not just the food that's the issue, it's the body's reaction to it.
Simultaneously with nutrition, I focus on digestion.
The adage, "you are what you eat" is no longer, rather, "you are what you absorb" is of utmost importance.
I treat a lot of digestive issues from bloating to heartburn to constipation.
Digestion can be affected by:
- Poor food choices (nutritionally deplete foods and additives)
- Poor eating habits ("eating hygiene")
- Trigger foods
- Imbalanced gut flora
As a naturopathic doctor, I will identify the root cause and provide individualized treatment options unique to your needs.