The Atkins Diet. The South Beach Diet. The Paleo Diet. The Mediterranean Diet. The Keto Diet. Jenny Craig. Weight Watchers. Awaken 180. Isagenix. Most of us have heard of at least some of these diets and meal replacement programs. While each has its supporters and detractors, they share the common goal of improving our well-being via healthy eating habits. “Which one is best for me?” is a question that commonly arises in our office. To explore the ever-growing list of options, I reached out to Marc O’Meara, our nutritionist at PersonalMDs.
Brad: How do people know which diet is the “right diet” for them?
Marc: Rather than advocating a specific diet or meal replacement program, I encourage my patients to focus on the nutritional content of their meals.
Brad: What does science tell us about the general principles of a healthy diet?
Marc: A plant-based diet is the best place to start for healthy eating habits with some animal products included. This means a diet that contains a lot of vegetables, nuts, seeds, and fruits. A plant-based diet filled with healthy nutrients is associated with a lower risk of cardiovascular disease and diabetes. Think of nutrients as an army that enters our bodies to protect our organs.
Phytonutrients (plant nutrients) are the best soldiers in this army. Fruits and vegetables with a deep color or strong aroma contain the most healthy nutrients. For example, blueberries and pomegranates have a dark, saturated color throughout and contain more nutrients than bananas which have a more pale color. Vegetables with deep, vibrant colors such as spinach, kale, and swiss chard are also very nutritious.
Some phytonutrients have anti-oxidant properties. This is analogous to a car with its protective paint. Oxidation in our bodies is similar to the rusting of a car. We try to prevent our cars from rusting to protect the metal underneath. The anti-oxidant effect of phytonutrients helps keep our organ systems healthy. Some phytonutrients reduce the amount of cholesterol that becomes oxidized. Oxidized cholesterol has been associated with an increased risk for developing clogged arteries. Other phytonutrients may help reduce the abnormal proliferation of cells and blood vessels which can reduce the risk of some cancers.
Brad: Are there certain foods we should try to avoid?
Marc: There are no foods I tell patients to avoid. I encourage people to limit white foods and products such as processed breads and sugar. These generally contain a lot of carbohydrates that have low nutrient value and thus are not a balanced food product. They do not provide much benefit for our bodies.
Brad: I’ve heard you counsel our patients that carbohydrates should always be accompanied by a protein. Why do you advise this?
Marc: When one eats a meal that contains just carbohydrates, the sugar rushes into our bloodstream, resulting in a rapid spike in our glucose levels, followed by a rapid decline. This places a strain on the pancreas, as the pancreas suddenly needs to release a lot of insulin to counter the glucose spike. Not only is this unhealthy for the pancreas, but it also can leave us feeling hungry soon after the meal is consumed.
Including a protein and/or a healthy fat with the carbohydrate slows the absorption of the carbohydrate. The protein acts like a dam which prevents the carbohydrate from suddenly rushing into the bloodstream. Avoiding this carbohydrate rush can result in more sustained energy, improved brain function, a better mood, and gives one’s body time to burn it off. If the carbohydrates come flying in at once, it is difficult for our bodies to use them. Unused carbohydrates often get stored as fat. However, if the carbohydrate is absorbed more slowly, there is a better chance that our bodies can utilize the carbohydrate without converting it into fat.
This is the concept of a low glycemic index diet. By slowing the rate of carbohydrate absorption into our bloodstream, we have a better chance of managing our glucose levels and, secondarily, our weight. Avoiding a sudden sugar rush lessens the demand on the pancreas.
Brad: What about eating fruit? Some of my diabetic patients have been told to avoid eating fruit because they are high in sugar.
Marc: While fruits do contain sugar, they also have a lot of healthy nutrients. People often eat fruit alone as a snack. I advise my patients to pair fruit with a protein or a food with both a protein and a healthy fat, such as nuts, Greek yogurt, or a piece of cheese. This slows the absorption of the sugar which leaves one feeling more satiated from the snack, and gives the body more time to burn those calories.
Brad: What does a healthy plate look like?
Marc: I’m a proponent of a balanced plate. Half of the plate should consist of vegetables or salad, while a quarter of the plate contains a protein, and the remaining quarter has a carbohydrate. Carbohydrates that have a color and contain fiber are healthier. The carbohydrate portion of the plate should not be larger than the protein. I advise fruit as a healthy carbohydrate choice, followed by whole grains such as quinoa, farro, or whole grain breads.
Brad: What type of animal protein do you recommend?
Marc: I encourage lean proteins which include all types of seafood and poultry. I prefer skinless poultry. Dark poultry is OK too. I advise people to limit their intake of saturated animal fats. Red meat is not as healthy as leaner meats because of the saturated fat content, which can increase one’s cholesterol and risk of heart disease.
Brad: What are common misperceptions of what constitutes a healthy diet?
Marc: I often hear that eggs raise one’s cholesterol. This theory has been debunked. Dairy fats such as cheese, butter, and ice cream contribute to elevated cholesterol much more than eggs.
Some people think that almond milk is healthier than regular cow milk. While almond milk is low in calories, it contains only carbohydrates so it should be consumed with a protein. Cow milk is more balanced than almond milk, as cow milk contains protein. Now, almond milk can be easier to digest – less bloating, less abdominal discomfort, and less gas – so it is preferred by some who have lactose intolerance.
Another common misconception is that we need to maintain a low fat diet. This trend developed in the 1990’s. I try to encourage my patients to eat healthy fats which are plant-based. Avocado, olive oil, and clear salad dressings (vinaigrettes) are some examples. Mayonnaise is also a healthy fat – it is made from vinegar and oil. The Mediterranean diet is high in healthy fats and has been shown to be beneficial for our health. As we entered the 2000’s, the pendulum shifted away from a low fat diet to a diet that contains healthy fats. Healthy fats make food taste better and slow gastric emptying, which allows food to be digested over a longer period.
Many people think that breakfast cereals are healthy, but oftentimes they are not. Lots of cereals are transformed into sugar after they are digested. If you enjoy cereal for breakfast, the portion size should be small and it should be accompanied by a protein such as nuts. Fiber-containing cereals do not control blood sugar as well as protein and healthy fats do. It is common for cereal eaters to become hungry before lunch. For those who do eat cereal, I recommend oatmeal and the higher fiber cereals as they take longer to absorb. Our bodies need to digest the fiber first before absorbing the carbohydrate inside.
Brad: What are your thoughts about the many diets that have been promoted over the years? The Atkins diet? The South Beach diet? The Paleo diet? The Keto diet?
Marc: I consider these diets to be short-term solutions because they are difficult to maintain. What does one do when they are no longer able to adhere to the diet? A modified Paleo or a modified Atkins sometimes work better because they are easier for people to sustain. Most of these diets are about keeping healthy blood sugar levels.
Brad: Your thoughts on intermittent fasting?
Marc: A fasting diet is all about caloric intake. Eliminating food for an entire day keeps your calorie count low, but it doesn’t rid your body of toxins. Some people report that they feel good on their fasting days, but this may reflect how they are eating on their non-fasting days.
Brad: Are meal replacement programs such as Isagenix or Optavia effective for achieving weight loss?
Marc: Some of these programs can be effective because they provide balanced meals with a low glycemic index. These diets are mainly targeted for those who are trying to lose weight. The question is: what happens when an individual stops one of these meal replacement programs?
Brad: Should we continue to count calories?
Marc: Calorie counting helps with weight loss, but it’s only effective if one can keep their calories low and still feel full.
Brad: What happens to our metabolism as we get older?
Marc: Our metabolism starts to slow around age 40. If we do not stay active and maintain muscle mass, our metabolism slows more quickly. When we lose muscle, we lose some of our capacity to burn the calories we ingest. Our metabolism is fastest around noontime and slows down in the evenings. This is why I advise my patients to avoid eating large dinners.
There was a study that showed that those who eat snacks late at night have a more difficult time losing or controlling their weight compared with those who do not snack after dinner. If you eat a balanced dinner, you should not need to snack afterwards. I ask my patients, are you snacking after dinner because you feel hungry or is it a habit? Snacks at night more easily turn into fat because our metabolism is slower, we may not need these extra calories, and we therefore do not burn much of what we eat.
Brad: Are juices and smoothies healthy?
Marc: If the juice or smoothie contains protein and is well-balanced, it can be part of a healthy eating plan. Fruit juices, however, cause significant spikes in blood sugar. Vegetable juices with a touch of fruit are healthier because they do not cause a sugar spike. Juices containing dark green vegetables have a lot of beneficial phytonutrients.
Brad: Protein bars: love ‘em or hate ‘em?
Marc: Some people replace breakfast with a protein bar. When choosing a protein bar, select one that has a good balance of protein and carbohydrates. Some protein bars are very good, but there are others that are just like candy bars. It is important to read the nutrition label to make sure the protein and carbohydrate are well balanced. A balanced protein bar contains a similar amount of protein and carbohydrate. For instance, Nature Valley granola bars contain 28 grams of carbohydrate with 2 grams of protein which is not good. This will cause a big-time spike in blood sugar. However, Nature Valley protein bars have similar protein and carbohydrate content which results in slower absorption, leaving us feeling fuller afterwards.
Brad: For those who are trying to lose weight, what is more important: diet or exercise?
Marc: Recent studies show that poor eating habits contribute 80%, while lack of exercise is responsible for about 20% of the problem. Many of my patients work out regularly and burn off their calories at the gym, but then they return home and eat unbalanced meals. They keep shooting themselves in the foot because their workout program is accompanied by poor eating habits, which keeps putting the fat back on. Exercise is important because it makes us feel better and allows us to maintain muscle mass which helps with our metabolism and bone density. However, unbalanced plates, large portion sizes, and evening snacks make it difficult for many to lose weight.
Brad: Thank you so much for providing your expertise and insight. I know this will be very informative for our patients.
Marc: I’m happy to help.
If you wish to learn more about how good eating habits can enhance your health and overall well-being, Marc is available by appointment for all members of PersonalMDs. He offers both individual counseling and group classes. To schedule a visit with Marc, you may send us an email or call our office, and we will be happy to facilitate an appointment.
Wishing you a healthy summer with good eating!
Brad Weiner, MD
This blog is for informational purposes only. It does not replace medical care from a licensed physician. Please contact your doctor if you have any questions or concerns.
