My approach to healthy eating is much like my approach to housework. I aspire to a clean and tidy house. I have systems in place to contain the chaos. My house is never perfect, and I don’t expect it to be, but neither do I want to live in squalor. Actually, now I think about it, my approach to healthy eating is a lot better than my approach to housework, as I value health more than hygiene and tidiness! So forget about that metaphor but let us proceed…
I ask all my patients about their diet, for many reasons. One is that it’s a powerful predictor of outcomes – both immediate and long-term. Another is that it tells me a lot about their lifestyle, emotions, and beliefs. Many of my patients are nervous when asked about their diet. They might fear judgement. Some don’t know whether they have a healthy diet or not, and if they should eat this or that. Some ask me if they should be following a specific diet, should they try intermittent fasting, and what do I think about the Paleo diet, eating soy, eating chia seeds, should they avoid grains, or give up coffee or chocolate. (I rarely tell anyone to give up coffee or chocolate – just reduce it!) Most are relieved to find that I am fairly relaxed when it comes to healthy eating. I don’t subscribe to any particular eating pattern, though I vaguely head towards the Mediterranean diet, for my personal cholesterol issues. I am also a realist. I know that people are leading real lives, often chaotic lives, and lunches are grabbed in between driving all day for sales assistants, or there is barely time for toast in the morning if you are a mum of schoolchildren. I know that in the evenings it’s easy to reach for sweets after dinner, in the mornings for a muffin with your coffee. So here’s my personal philosophy on eating healthy, one that I subscribe to personally as well as try to impart to my patients, if they are interested.
1. Eat real food.
This means food closest to its original form as possible. This gives you the most nutrients and least additives. It’s also cheaper. Real food usually doesn’t come in a shiny packet, box or jar. (well, almonds come in packets I guess…) But you know what I mean. I hope. If not, PM me.
2. Eat a variety of food. Don’t eat the same thing every day. I have known patients to live on a diet of almonds, rice milk and kale. Apart from sounding like a terrible existence, it’s also nutritionally unbalanced. Eating too much of anything, even if it’s a “superfood”, is not healthy. Nutrition is very complex, and we still don’t understand it well. Eating the same thing every day means you might not absorb the variety of nutrients that you need, or you might absorb too much of a toxin. For example, fish is heart-healthy but it is also contaminated with dioxin, which has been linked to cancers. So eating fish at every meal will not help you in the long run.
3. Eat what you enjoy. I know someone (ok, she’s my mum) who eats walnuts every day because they’re “good”. My mum hates walnuts. But she eats walnuts every day. Ugh. I hate walnuts too (perhaps it’s genetic?) but I refuse to eat them at all. I will eat other nuts that I enjoy. Life is too short. Lose the gross superfood that you can’t bear to eat.
4. I get asked if avoiding dairy or wheat is a good or bad thing. It depends. If you have symptoms on dairy and wheat, don’t have those foods. If you have coeliac, of course you should avoid gluten. Additionally, if you have symptoms on wheat, it is likely to be due to a fructose intolerance. You should also avoid excessive wheat and dairy consumption (see 2). If you want to avoid these foods, go ahead, but ensure you are eating a variety of other foods as well (see 2). But if you enjoy bread and cheese, please don’t stop. You might need to cut down on cheese a bit, and I definitely don’t recommend eating lots of white flour; we also eat a variety of grain substitutes like quinoa and buckwheat (pseudo-cereals, apparently, but again see 2).
5. I also get asked about sugar. Is it “bad”? Is our epidemic of diabetes and obesity due to sugar? The truth is, we don’t really know yet. Sugar makes food palatable. We certainly need very little of it in our lives, but I don’t think we need to avoid it altogether. I like the idea of moving on a spectrum towards healthier eating. I personally allow myself one dessert a week. Some weeks I actually stick to this. Other weeks I might sneak in a biscuit or two. I bake with sugar substitutes but I try to remind myself that it’s just sugar in another form. In other words, I’m trying to have a healthy relationship with sugar. Not an addictive one.
6. If you have a craving, it’s telling you something. It could be any of the following: You’re hungry. You’re bored. You’re tired. You’re sad/anxious/having another emotional issue. You’re not getting the nutrition that you need. This last one is an important one. I don’t think it’s proven in any scientific research, but I believe that if you’re undernourished, your body tells you to keep eating in the hope that you actually eat something that’s good for you. You know, with minerals, vitamins, antioxidants, protein, fibre etc. But if you keep reaching for a donut, you’re not getting any nutrition, and you’re still hungry. Anyway, I always ask my patients: what is this telling you?
7. And lastly – this is the most important thing of all. All the palaver about whether we should avoid grains, fat, sugar, or dairy is just a storm in a teacup. There are vigorous debates for and against. Saturated fat is bad. No it’s not, eat more meat. Everyone is missing one crucial point, the missing link. EAT MORE VEGETABLES!! If you make vegetables the focus of your plate, you will naturally reduce the proportion of fat, sugar, grains and dairy that you consume. So put those vegetables first. I don’t care if you eat them raw, juice them, soup them, stir fry or steam or bake. Just eat them! Lots of them. Five serves. Lots of colours. With every meal as much as you can. I think the reason the poor vegetables haven’t had their own campaign is that nobody is going to make a lot of money if people eat more vegetables. The cattle industry, poultry industry, packaged food industry, gluten-free industries aren’t going to profit from it.
Lastly, a word about developing a healthy relationship with food. Food nourishes but also brings pleasure. Enjoy it. Please don’t eat walnuts if you hate them. (Or kale). Please enjoy a little treat every weekend. If you like Timtams, eat them once in a while. Please partake of the wonderful culinary offerings from the many cultures that flourish all around the world. Please eat birthday cake when it’s your birthday. I am speaking as someone who once had an eating disorder, and who is thankfully well and truly recovered. Food is love, so eat real food most of the time, choose your treats carefully, and love yourself in the process.