Over the past few months, I’ve written a number of times on how nutrition recommendations are seldom supported by science. I’ve argued that what many people are telling you may be inaccurate. In response, many of you have asked me what nutrition recommendations should say.
It’s much easier, unfortunately, to tell you what not to do. But here at The Upshot, we don’t avoid the hard questions. So I’m going to put myself on the line. Below are the general rules I live by. They’re the ones I share with patients, with friends and with family. They’re the ones I support as a pediatrician and a health services researcher. But I acknowledge up front that they may apply only to healthy people without metabolic disorders (me, for instance, as far as I know).
These suggestions are also not supported by the scientific weight of rigorous randomized controlled trials, because little in nutrition is. I’ve inserted links to back them up with the available evidence. They are not “laws” and should not be treated as such. No specific nutrients will be demonized, and none will be held up as miracles. But these recommendations make sense to me, and they’ve helped me immensely.
Full disclosure: I did not invent most of these. I’ve developed them from reading the work of others, including what may be the most impressive “official” nutritional guidelines, those of Brazil, as well as from earlier suggestions from readers, as in this great NYT interactive graphic. It captures readers’ responses to food rules by Michael Pollan. He is, of course, the promulgator of the well-known advice: “Eat food. Not too much. Mostly plants.”
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1. Get as much of your nutrition as possible from a variety of completely unprocessed foods. These include fruits and vegetables. But they also include meat, fish, poultry and eggs that haven’t been processed. In other words, when buying food at the market, focus on things that have not been been cooked, prepared or altered in any way. Brown rice over white rice. Whole grains over refined grains. You’re far better off eating two apples than drinking the same 27 grams of sugar in an eight-ounce glass of apple juice.
1b. Eat lightly processed foods less often. You’re not going to make everything yourself. Pasta, for instance, is going to be bought already prepared. You’re not going to grind your own flour or extract your own oil. These are meant to be eaten along with unprocessed foods, but try to eat less of them.
1c. Eat heavily processed foods even less often. There’s little high-quality evidence that even the most processed foods are dangerous. But keep your consumption of them to a minimum, because they can make it too easy to stuff in calories. Such foods include bread, chips, cookies and cereals. In epidemiologic studies, heavily processed meats are often associated with worse health outcomes, but that evidence should be taken with a grain of salt (not literally), as I’ve written about before.
2. Eat as much home-cooked food as possible, which should be prepared according to Rule 1. Eating at home allows you to avoid processed ingredients more easily. It allows you full control over what you eat, and allows you to choose the flavors you prefer. You’re much less likely to stuff yourself silly if you eat home-cooked food. I’m not saying this is easy. Behavioral change takes repetition and practice. It also, unfortunately, takes time.
3. Use salt and fats, including butter and oil, as needed in food preparation. Things like salt and fat aren’t the enemy. They are often necessary in the preparation of tasty, satisfying food. The key here is moderation. Use what you need. Seasoning is often what makes vegetables taste good. Don’t be afraid of them, but don’t go crazy with them either.
4. When you do eat out, try to eat at restaurants that follow the same rules. Ideally, you should eat at restaurants that are creating all of their items from completely unprocessed foods. Lots and lots of restaurants do. Follow Rule 1 even while out to dinner. Some processing is going to be fine, but try to keep it to a minimum.
5. Drink mostly water, but some alcohol, coffee and other beverages are fine. As I’ve pointed out before, you can find a study to show that everything either prevents or causes cancer — alcohol and coffee included. But my take is that the preponderance of evidence supports the inclusion of a moderate consumption of most beverages.
6. Treat all beverages with calories in them as you would alcohol. This includes every drink with calories, including milk. They’re fine in moderation, but keep them to a minimum. You can have them because you like them, but you shouldn’t consume them as if you need them.
7. Eat with other people, especially people you care about, as often as possible. This has benefits even outside those of nutrition. It will make you more likely to cook. It will most likely make you eat more slowly. It will also make you happy.
I’ve avoided treating any food like the devil. Many nutrition experts do, and it may turn out they’re right, but at this point I think the jury is still out. I’ve therefore tried not to tell you to avoid anything completely. My experience tells me that total abstinence rarely works, although anecdotes exist to support that practice. I think you’ll find that many other diets and recommendations work under these rules. These are much more flexible and, I hope, reasonable than what some might prescribe.
All of these rules are subtly trying to get you to be more conscious of what you’re eating. It’s far too easy these days to consume more than you think you are, or more than you really need, especially when eating out. I’ve found that it’s impossible to tell any one person how much they should be eating. People have varying requirements, and it’s important for all of them to listen to their bodies to know when they should eat, and when they should stop.
One other thing: Don’t judge what others eat. One of my closest friends has been avoiding carbohydrates for months, and has seen remarkable results. Another was a pescatarian — a person whose only meat dishes are fish — for a year and was very happy with that. I, on the other hand, avoid no food groups in particular.
People are very different. Some may have real problems consuming even the smallest amount of carbohydrates. Others may be intolerant of certain foods because of allergies or sensitivities. It will most likely take a bit of experimentation, on an individual level, to find the actual diet within these recommendations that works for you. But the above rules should allow for a wide variety of foods and for remaining healthy. At least, I hope so.
I’m curious what readers think of these. I welcome your comments to this column, as well as tweets to me in response.
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1091 Comments
LAW
Charleston, SC December 7, 2016Donna Sturm
NYC November 29, 2016Marcy Goldman
November 28, 2016
stephen g
chicago November 28, 2016jim
san diego November 25, 2016Jill C.
Durham, NC November 23, 2016Hidden underneath all the holier-than-thou-ness I see here is a judgmentalism -- of the overweight, of the poor, of those who do not spend every spare minute at the gym. The article makes good sense. The comments consist of I Know All the Answers So You Should Listen To Me. The way I eat is: Listen to my body, give it what it wants. In moderation.
Jimmy
San Francisco November 23, 2016Shirley Ricci
Florida November 23, 2016Karen
Sonoma November 28, 2016Jocelyne
Montreal November 16, 2016The Pooch
Wendell, MA November 20, 2016"Quality foods", whole, nutrient dense, with sufficient protein and fat, satiate the appetite with fewer total calories compared to highly processed, nutrient poor, refined-carb foods. "Eating less" is an _effect_ of nutritional quality.
Energy balance is supposed to be unconscious, just like breathing, thirst, or blood pressure.
Dr.Ranjith Valath
Chennai India November 16, 2016Gonzalo
CDMX November 9, 2016Hank
NYC September 28, 2016Sarah
Mass. September 25, 2016N.G. Krishnan
Bangalore, India September 23, 2016Ayurveda explains relationship between taste, appetite, and the power of digestion. Often we simply connect tastes and flavor with enjoyment value rather than connecting tastes with its corresponding therapeutic value. Ayurveda has an elegant explanation and provides a correlation which considers the natural order of these six tastes sweet, sour, salty pungent, bitter and astringent and the corresponding stages of digestion.
In Ayurveda, diet is the first and most basic building block of good health, and can be an effective way to maintain health or treat disease.
Improper diet is the main underlying physical factor that induces disease, according to Ayurveda, so, when we modify the diet, we also get at one of the underlying problems. Ayurveda primarily evaluates the diet based on the energetic qualities of the food, and its effect on the body’s overall physiology, not necessarily on the chemical nutrient content.
Digestion begins when you first begin to think of food. When your victuals are well selected, properly prepared and presented beautifully, your senses will start the digestive process and continue to aid assimilation
JohnB
overseas September 21, 2016Re: "Use salt...as needed in food preparation": the science is still inconclusive about salt use and hypertension. "Inconclusive" in the sense there is no straightline chart plotting increased blood pressure vs increased salt use. What is conclusive about the science is there is no reliable way of predicting which individuals will produce this straightline chart. All you can do is suck-and-see.
My blood pressure was elevated to the point of needing remediation. Before prescribing any medication my family quack asked me to try a lower salt regime. I tried it and my blood pressure declined to normal for my demographic. I happen to be a (lucky) responder.
David Clayton
San Diego September 21, 2016Jeffrey B.
Greer, SC September 21, 2016My Internist also added one thing. Nature is giving us hints; try to put different colors on your plate, and he recommended yellows and greens. I feels better, and everything inside works better, too.
Eyefly
Michigan September 21, 2016C.R.
Toronto, Canada September 7, 2016Peter Lawton
South Africa September 4, 2016Virginia
Virginia September 1, 2016Patty
California August 27, 2016But there are ways to use the microwave to eat healthy as I have discovered recently in my quest for a better diet. Microwaveable rice packets are ready to eat after only 90 seconds in the microwave. (Just make sure to pick the ones that are low in sodium!) And a microwaveable steamer can steam fresh veggies in les than 5 minutes. Add some pre-cooked rotisserie chicken (heated up in the microwave of course) and bam: healthy dinner in less than 10 min, with virtually no cleanup afterwards. Want breakfast? Use the microwaveable omlette maker: you scramble the uncooked eggs, then pour into the container and nuke for a minute or two. It's possible, folks!
Karini
Rural August 26, 2016Jeremy
New Zealand August 26, 2016John H.
New York, NY August 26, 2016James Kling
Harrisburg, PA August 28, 2016dm
Stamford, CT August 29, 2016frugalfish
rio de janeiro August 26, 2016We haven't used a can opener in years except for specialty foods (smoked clams). We eat frozen veggies maybe once a month and are always disappointed in comparison to fresh food.
The Brazilian guidelines are designed for people living in Brazil, which is why they're so good. I didn't even know about them until reading the article, but once I did I saw how well they fit life here.
RAR
California August 26, 2016Jeremy
New Zealand August 26, 20161091 Comments