What happens when people eat right, maintain a healthy weight, exercise, and don’t smoke? They prevent 80% of heart attacks, 90% of type 2 diabetes, and significantly reduce the chance of cancer, dementia and pretty much every other bad thing you can think of.
But we’re, uh, not very good at eating right. When Harvard researchers analyzed the average American diet, it scored a 48 out of a possible 110 in terms of health. Yeesh.
Unfortunately, what we call “living life to the fullest” might also mean living it to its shortest. But it’s not all your fault. We get terrible information – when we get any clear information at all. Diet books are an appalling literary swamp of malignantly useless falsehoods, the food industry spends billions to tell us that whatever they’re selling is good and the media loves promoting the latest one-off study as eternal truth. We’re all ready to declare epistemological bankruptcy. I don’t blame you if you’re at the point where you say, “Screw it. I’m eating what I want because I can’t get a straight answer.”
Unfortunately, biology does not have an appeals process and Mother Nature doesn’t take IOU’s. We desperately need a Better Business Bureau for nutrition. Well, a while back I drilled down on the real science of weight loss and exercise, so this time I went digging for the real answers on eating right. And I found something…
A book that hissed and crackled with scientific power. I was blinded by its Damascus light. I clung to it like a lifeboat in an ocean of wrong. Walter C. Willett, MD, has led the Department of Nutrition at the Harvard T.H. Chan School of Public Health for over twenty-five years and is a professor of medicine at Harvard Medical School. His book is “Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating.”
My inbox is rolling its eyes in anticipation of angry emails. This post is inevitably an exercise in masochism because what is “healthy” is something a lot of people have a lot of strong opinions on — many of them seemingly invulnerable to reason or evidence. (Whenever I write something, somebody gets angry. Sometimes it’s me.) Please keep an open mind and resist your Dietary Stockholm Syndrome. This is the best evidence science has.
Let’s get to it…
We’re gonna start with the brass tacks. (No, don’t eat brass tacks. It’s unlikely your diet is brass deficient.) If you usually skip to the “sum up” section at the end of my posts, this is for you:
You’ve heard much of this before. It’s very similar to “The Mediterranean Diet.” That plan started with the work of Ancel Keys in the 1950’s when he did “The Seven Countries Study” which was the first big analysis of the link between diet and heart disease. He found that people in Greece and southern Italy that ate this way had crazy long life expectancies as well as shockingly low rates of heart disease and cancer. Subsequent studies have shown this pattern of eating works for improving health in most everyone.
Alright, I need to make a little side note here to mention something obvious that recent debate has rendered less obvious: weight matters. Eating healthy is vital but that doesn’t mean eating too much isn’t an issue and don’t let anyone tell you any different.
How much you weigh in relation to your height, your waist size, and how much weight you gain after your early twenties are strongly correlated with heart attack, stroke, cancer, blood pressure, diabetes… Anyway, it’s bad. Too much food can be as bad as bad food.
Okay, let’s get down to the nitty and the gritty…
Eating fat is not tied to heart disease or even to adding excess weight. If anything, it’s the reverse. People who eat a higher proportion of fat are often leaner and healthier. The pipe bomb in the ointment is the type of fat you eat.
Simply put: monounsaturated and polyunsaturated fats are good for you, saturated fat is not good for you and artificial trans fats are straight out of a Japanese horror film.
Artificial trans fats usually come in the form of partially hydrogenated oils. In English: avoid margarine, vegetable shortening, most doughnuts, pastries and cookies, powdered creamer, and the fats used for deep-frying fast food in restaurants. This stuff is so bad you can actually see the strands of your DNA unwinding if you look close enough. Seriously, some artificial trans fats have already been banned due to health concerns. They up the chance of heart disease, diabetes, dementia, and being struck by a meteor.
Aside from avoiding trans fats altogether, many people try to replace fat with carbs but that’s not a great idea either. The goal is to replace saturated fat with monounsaturated and polyunsaturated fats. What’s that mean in English?
Replace red meat with poultry, fish, avocado, or nuts whenever possible. Use olive oil instead of butter or margarine. No, eggs aren’t bad. Walter says, “No research has ever shown that people who regularly eat eggs have more heart attacks than people who don’t eat eggs.”
And get those Omega 3 fatty acids. Salmon, trout, sardines, walnuts, flaxseed or supplements are great sources.
Okay, that wasn’t too painful. This, however, will be…
Eat more whole grains. Reduce less refined carbs and sugar. Yes, that means fewer cake-based foods. (Judging by the way I am sobbing you can tell I’m not thrilled about this either.)
Long-term studies link refined carbs with increased risk of heart attack, stroke and so much diabetes it will give your diabetes diabetes.
Whole grains rule. Women who ate 2.5 servings a day of whole-grain breakfast cereals, brown rice, or whole-grain bread were 30% less likely to get heart disease than women who ate 1 serving a week. Yes, it’s a big deal. Walter writes, “We estimated that eating a bowl of cold breakfast cereal that supplies about 5 grams of fiber cuts the chance of developing heart disease by about one-third compared with a fiber-free breakfast…”
You want any whole-grain food to have at least 1 gram of fiber for every 10 grams of carbs. Yes, that’s a lot and probably a big transition for most of us. So, uh, be aware of potential increased bathroom side effects. (Yes, your colon is going bowlin’.)
So what are you supposed to eat?
High fructose corn syrup is not as bad as it’s been made out to be. (Here come the angry emails. I can hear them…) Look, I didn’t say it was good. I’m just saying it’s not Evil Galactic Death Poison like the media portrays it. Walter says it’s as bad as sugar. Which isn’t great. And, no, “natural sugar” isn’t any better. Just reduce all sugar, including high fructose corn syrup.
I like steak. Do you like steak? If so, get some tissues…
You want to get more of your protein from plants, beans, nuts, fish, and poultry.
Eat too much red meat or processed meat and you may be sliding into cancer’s DM’s. The International Agency for Research on Cancer concludes that processed meat is “carcinogenic to humans,” and red meat is “probably carcinogenic.” And the saturated fat from red meat and processed meat contributes to heart disease and overall premature death.
I am quickly cycling through the Kübler-Ross stages right now. Gotta reduce that red meat. And processed meat is out. (Yes, that includes bacon. Yes, I know you hate me. We already established that in the carb section.)
Fish, chicken, beans, and soybeans are all healthy protein sources. Nuts are really good. An ounce of them provides about 8 grams of protein, which is the same as a glass of milk. They’re loaded with fat – but it’s the good kind. The research on soy foods is conflicting but it’s definitely better than red or processed meat.
Okay, time to talk about that stuff you buy and then slowly allow to go bad in your refrigerator…
Some things in nutrition are clear. Nobody ever said, “Don’t eat too many green vegetables.” Fruit and veggies are capital-G Great. (That said, I eat them with roughly the frequency of a Halley’s Comet fly-by. I am a mere mortal and sometimes a lot less than that.)
Large meta-analyses link eating lots of fruit and vegetables with “lower risk of dying from any cause.” (Apparently, they can stop bullets.) The most benefits were found when people ate five servings a day. And get a variety of them in your diet. Different fruits provided protection from different cancers, so mix’em up. An easy way to do this is to eat fruits of various colors. Sounds funny, but research shows it works.
Berries were shockingly beneficial. Eat more of them. Meanwhile, potatoes and corn act more like refined carbs in your body. Limit them.
One more thing to keep in mind here: smoothies are not the solution. You end up with more sugar and calories. And limit fruit juice as well. Eating fruits and vegetables reduced the chance of diabetes while drinking fruit juice increased it.
And while we’re talking about drinking things…
The idea that you need 8 glasses of water a day does not hold H2O. You get a fair amount of the water you need from food. More water is, on average, good — but there’s no need to drive yourself crazy.
Water should be your preferred drink of choice. Bottled is not necessarily better than tap. (Bottled doesn’t always meet EPA guidelines that tap water has to.) In blind taste tests, people actually preferred tap to bottled, believe it or not.
Do I need to say sugary soda is bad? Fine, fine, here you go: “In a meta-analysis that included nearly 500,000 men and women followed for an average of twenty-two years, the risk of developing type 2 diabetes went up by 13 percent for each daily serving of sugar-sweetened soda or juice….”
Milk is great for kids and the elderly. Adults can overdo it. It contains a good deal of saturated fat and lots of calories. Most adults don’t need the extra calcium. Go easy.
Coffee is great. (I hope this makes up for the news about bacon.) It has a dizzying list of positives like lower incidence of diabetes and Parkinson’s disease, less liver cancer, reduced kidney stones and gallstones, and lower overall mortality. It even reduces depression (which, if you are reading this first thing in the morning, probably does not surprise you). Go easy on the sugar, cream, etc. It’s coffee, not a hot milkshake.
Tea is nice but doesn’t deliver the mystical, quantum healing effects you might have heard. No clear evidence for reduction of cancer. Heart disease results are mixed and contradictory.
Yes, in modest amounts, alcohol raises good cholesterol and reduces the chance of heart attack and stroke. And most of those results are seen exclusively in younger people. Sorry. Most importantly, it does not improve your driving. And drinking more than a modest amount increases liver disease, cancer, high blood pressure, bleeding strokes and the chance you’ll think you can take that tattooed biker in a fist fight. One drink a day for women, two for men is the healthy limit.
Should you swallow any vitamins with your beverages? There are fifty bazillion supplements and if I covered the ups and downs of all of them you’d kill me. Luckily, most of them are fortified nonsense. Unless you’re addressing a legitimate medical condition, the only thing you probably need is a daily multivitamin. Consider it cheap insurance. Making sure you get the basics (especially vitamins B6 and B12, folic acid, vitamin D, and beta-carotene) is helpful in preventing heart issues, cancer, memory loss and other chronic diseases.
(And, no, Vitamin C megadoses are not going to reduce your chance of getting a cold. They just make your urine more expensive.)
Whew. That was a lot. Let’s round it all up – and we’ll get some very specific, easy things you can do immediately to start implementing this dietary overhaul…
Here’s how to eat healthy:
Okay, enough of me ranting and raving about technical aspects of nutrition like some 21st century Howard Beale of the internet (and if you get that joke, you’re eligible for the senior discount).
How to get started may seem daunting and lead to enraged hyperventilation at all this information. So here are a few easy ways to begin the transition:
As I look at the distance between now and my date of birth, I realize I’m closer to the end than to the beginning. The good news is we can all push the ending farther away if we try. We just need good information (check) and to do the work.
From what I hear, immortality can get a bit lonely, so keep the above in mind when preparing food for those you love — or share this post with them.
Eat right, live longer and feel better. But most importantly:
I’m sorry about the news on bacon.