I love food. I love growing it, reading about it, cooking it, and most of all, eating it! And as we love to say in the world of natural healing, “Let food be thy medicine and medicine be thy food.” Thank you, Hippocrates, but I’m pretty sure he would never have guessed it could become quite so fraught. From food politics and climate change, to intolerances, GMO, and pesticides, it’s all a muddle.
It sounds like a rough start to what will hopefully be a useful piece of information, breaking it all back down to basics. A word of warning, after reading this you will not walk away with the perfect meal plan or even a guide on what macros to hit … that fun part is for you to work out. But we will look at what’s important to consider when choosing your food, what traps to avoid and when to seek help.
In his book Outlive[1] Dr Peter Attia dedicates a few chapters and not a modest amount of research to food and dieting. It is, after all, one of the four cornerstones of health, along with movement, sleep, and emotional wellbeing. There are a few fundamentals that we agree on – there is no perfect diet, and depending on your health status and goals, it may change over time. Also, and very importantly, you should find a diet that you can maintain.
And apart from your health goals, there are a few more things to consider: what is your budget (health guru’s tend to have infinite resources to spend on organic produce), your personal likes and dislikes, whether or not you have allergies or intolerances (more on this in a bit), your genetics, and of course whether or not you are cooking for yourself of the whole family (this one is a corker!).
Let’s consider the whole discussion in the basic framework of What, When and How much to eat.
What to eat
I’ve always dreamt of being able to “eat breakfast like a king, lunch like a prince, and dinner like a pauper,” but my schedule has simply never allowed for this. In truth, this quote has been misinterpreted for decades and the author, Adelle Davis, in her 1954 book, Let’s eat right to keep fit, was talking about including the highest amount of protein in your first meal of the day to help regulate blood glucose levels.[2] She was quite the revolutionary and went against the grain of the ever-growing breakfast cereal industry. Her actual advice I do in fact implement. There is a growing body of evidence to support protein intake beyond the current recommendations – this will help with appetite regulation, weight management and healthy aging.[3] The other detail here, was that she was a huge advocate for eating real food.
And here comes your most important piece of advice … If it’s made in a factory, you should probably not eat it. No matter if you are vegan, carnivore, or anything in between, eat real, whole food, something that was growing or living at some point. Simple.
Now that we have you eating real food, you need to take care not to consume any nasties that sometimes come with it. The folks at the Environmental Working Group put together two useful lists, the Dirty Dozen[4] and the Clean Fifteen[5], to help you identify the fresh produce that has the highest or lowest pesticide residue. In a perfect world, aim for organic versions of the foods on the dirty list, and if you are unable to do so, take the time to wash the produce. A recent study[6] showed up to a 77% reduction in pesticide residue after washing with running water. If, however, you are looking at foods on the Clean Fifteen list, there’s less need to worry about the nasties and a quick rinse or peel will do the trick.
Hormones and antibiotics have long been used in animal husbandry to promote growth and feed performance.[7] It’s another hotly debated topic and there is evidence that this practice leads to the development of antibiotics resistant strains of bacteria,[8] and has carcinogenic and endocrine disrupting effects in humans.[9] And this is not to mention the deleterious effect it has on the environment.[10] If you are going to eat meat, try and make it from happy animals. Animals that were allowed to roam freely (or swim freely) and were not subjected to routine administration of antibiotics, hormones, or any other funky stuff. It will be more expensive, but also vastly more nutritious.[11],[12]
Now comes the scenario where a patient arrives at our rooms, they are eating a perfectly ‘healthy diet’, but despite this, face health challenges that can be traced back to what they are eating. We next need to consider allergies and intolerances.
Allergies
An allergy is an immediate adverse reaction to food (or another substance) triggering an Immunoglobulin E (IgE) mediated immune response. It affects roughly 3% of the population and has effects beyond the gastrointestinal tract. Food sensitizations usually start in early childhood and persist throughout life.[13] It can manifest in a few ways, such as a skin reaction, swollen lips, tight chest, sudden sinus symptoms, stomach pain or diarrhoea, and in severe cases, death. If you suspect an allergy, it is best to have it tested, as leaving it unchecked could have serious consequences. We would do a blood test and advice accordingly. The most common allergies are from egg, milk, fish, peanut, wheat, and soya and are the first ones we test for.[14]
Intolerances
This is where it gets interesting and where we often step in to help our patients. Intolerances are different from allergies in that they are mediated by Immunoglobulin G (IgG) and usually have a delayed response in the body. Often, we will see a few common offenders appear on the test results – wheat/gluten/gliadin, cow’s milk, casein, egg white, and then usually some variety of nut. Less common are vegetables, meats, or fish.[15] These patients could present with a variety of symptoms, from brain fog, water-retention and weight gain to persistent (or new) skin conditions or even joint pain. A period of elimination of the offending foods is followed by a very controlled and slow reintroduction. Here we test the body to see how it tolerates the food now that the immune system has calmed down. If care is not taken controlling some of these foods, the consequence may be the development of an autoimmune condition.[16]
To add another spanner in the works, we need to consider your genetics. Certain genetic polymorphisms, or SNPs, have been associated with lactose and gluten intolerance respectively. The latter predisposing one to developing coeliac disease if exposed to a diet high in gluten. These too can be tested for, and the foods avoided.
There’s no real certainty in the scientific community about why there is a rise in intolerances. Theories include the modification of grains, increased use in pesticides, over-processing of foods and a link to greater gut permeability (which in and of itself is a whole blog post). In the meantime, with the tools at our disposal, we can take a fair bit of guesswork out of the What to eat, avoiding frustration and certainly much discomfort.
When to eat
Time restricted feeding. Gosh, it really does sound like something that could only happen in a lab. But it’s real, and it’s helped many. The physiological basis lies in support of circadian rhythms, allowing for the coordination of cellular processes and therefor better health outcomes. When we eat in a specific window (not grazing in the fridge for midnight snacks, or late glasses of wine), we support a robust feeding-fasting cycle, potentially preventing and even reversing chronic disease.[17] It has also been shown that purely by restricting the time in which we eat, for example a 10-to-12-hour window, we automatically reduce our calorie intake by up to 20% (again, no late-night detours past the fridge).[18] This is a simple measure to implement and has the potential for great rewards. Combine this with an intention to eat only two or three meals and avoid snacking in-between, and you’re off to the races!
Once again, the research in this field is emerging, and for now you need to do what feels good for your body. Many women have come to our rooms, claiming that the ubiquitous 16:8, was life-altering, others could not dream of skipping an early breakfast. Tune in to your body and feel what works best for you.
How much to eat
According to Michael Pollan we should “Eat food. Not too much. Mostly plants.”[19] We can get behind this and so far it ties in quite nicely with what we have discussed. Let’s focus here on the ‘not too much’ bit. In his book Food Rules,[20] Pollan offers advice to help you with this, such as buying smaller plates and glasses, eating slowly (or mindfully) and to stop eating before you are full. This last point is borne out by the centenarians of Okinawa, who stop eating when their stomachs are 80% full.[21] We also tend to eat less when we are enjoying a meal with friends and family, at a table, delighting in interesting conversation. In our fast-paced lives and chaotic schedules, dinner time can be a great opportunity for busy families to connect.
Other than these practical tips it can get more nuanced, and we head back to the field of fasting, where calorie restriction takes the stage. It is well known that controlled calorie restriction has a positive effect on ageing and delays many age-related disease processes.[22] A recent study[23] from The Yale Centre for Research on Ageing found that calorie restriction has a positive effect on the thymus gland, improving both immunity and metabolic health. Although the aim in this study was to reduce calories by 25%, participants averaged out at 14% over the two-year period of the study. The ‘how’ of achieving this level of restriction is up to you. For some, skipping breakfast works well (see above on When), and for others 14% will equate to exactly one day of fasting in the week.
I’ve never seen sustained success with weighing food or calorie counting, although there’s something to be said for knowing what you are eating. If the numbers interest you, it may be worthwhile fiddling with apps such as Cronometer. You can input the data of your meal or certain types of foods and get complete breakdown of the macros, minerals, vitamins, fibre … the lot. It could prove helpful in how you approach planning your meals.
Never forget that food is indeed glorious and something to be enjoyed. And while this is not a treatise on weight loss, it holds true that inflammation and weight gain should not be a battle if you eat wholefoods that agree with your palette and constitution. If, however you find that you need guidance or are struggling with any of the issues discussed, please get in touch so we can guide you back to wellness.
References
[1] https://peterattiamd.com/outlive/
[2] https://portal.nifa.usda.gov/web/crisprojectpages/1004662-to-eat-breakfast-like-a-king-lunch-like-a-prince-and-dinner-like-a-pauper–testing-the-relationship-between-meal-proportions-and-obesity.html
[3] https://cdnsciencepub.com/doi/full/10.1139/apnm-2015-0550
[4] https://www.ewg.org/foodnews/dirty-dozen.php
[5] https://www.ewg.org/foodnews/clean-fifteen.php.
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498324/
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834504/
[8] https://www.sciencedirect.com/science/article/pii/S2213716519301985
[9] https://www.cambridge.org/core/journals/nutrition-research-reviews/article/hormones-in-international-meat-production-biological-sociological-and-consumer-issues/DFE318F3323B6886DCF8AAC6EC49D39A.
[10] https://www.sciencedirect.com/science/article/abs/pii/S0013935120313608
[11] https://onlinelibrary.wiley.com/doi/abs/10.1002/jsfa.9652
[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932594/
[13] https://www.sciencedirect.com/science/article/pii/S0016508515001973
[14] https://www.nhs.uk/conditions/food-allergy/
[15] https://www.sciencedirect.com/science/article/abs/pii/S156899721830212X
[16] https://www.sciencedirect.com/science/article/abs/pii/S0016508515007672
[17] https://www.sciencedirect.com/science/article/abs/pii/S1568163716303014
[18] https://www.cell.com/cell-metabolism/pdf/S1550-4131(16)30250-9.pdf
[19] https://michaelpollan.com/reviews/how-to-eat/
[20] https://michaelpollan.com/books/food-rules/
[21] https://info.bluezonesproject.com/power-up-80-percent