What you eat plays a leading role in your health and well-being. When a person eats healthy food, it helps protect against many chronic diseases such as heart disease, prediabetes, type 2 diabetes and obesity. But with so many innovative diets and nutritional recommendations, it can be difficult for patients to navigate what to eat and what not to eat.
Two AMA members took the time to discuss what they wish patients knew about healthy eating. They are:
- Stephen Davies, MD, a preventive cardiologist and executive director of the nonprofit Gables Institute in Chicago.
- Ethan Lazarus, MD, a family physician and bariatric specialist in Greenwood Village, Colorado. Dr. Lazarus is also the president-elect of the Society of Obesity Medicine.
That’s what these doctors said.
Dr Lazarus said there are many different ways to eat healthy, but “it’s not very helpful to ask people to eat more fruits and vegetables – they’ve already been told hundreds of times”, adding that “people have a good idea of what healthy food is but we tend to to eating in an unhealthy way though.”
“Instead of just focusing on what we eat, it’s a good idea to back up some steps and think about why we eat the way we eat because most of our eating behaviors are not predetermined by choice,” he said. “A lot of times we only eat what is there or what is served or because we are stressed, tired or bored.
“Thus, the first step should be knowing your eating patterns, your eating triggers, and why you’re eating a certain way,” Dr. Lazarus added.
“One simple way to stack the deck in your favor is to eat home-prepared meals as often as possible,” said Dr. Davies. When cooking at home, focus on “meals made with a mix of unprocessed, non-label foods, such as vegetables, beans, whole grains, and fruit.”
It’s important to note that “restaurant and fast food foods are often higher in calories and added salt than their home-cooked counterparts,” he said. This is because, “At home, you have much more control, and most people will eat much smaller amounts that contain much more healthy ingredients than those bought while jogging.”
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When thinking about eating, Dr. Lazarus said, it’s important to eat it as you would other healthy behaviors. Perhaps the most important thing anyone can do is learn an eating schedule and an eating plan.
“People who succeed in eating healthy don’t just try to make a decision at every meal – they already have a plan about what their day or week will look like,” he added. “We have to get away from eating randomly or what seems good and start eating on a plan.”
“Eating healthy food is one of the foundations of good health,” Dr. Davies said. “Even when medications are required, it is important to assure patients that medications alone cannot do everything.”
“Optimal health will always require attention to nutrition and lifestyle,” he said.
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“The most obvious way to eat more healthily is to be in tune with the signals from your body,” Dr. Davies explained. “For example, how do you feel after snacking on a donut compared to eating a piece of fruit or a handful of nuts? How about a burger and fries compared to a salad topped with beans or fish?”
While “fast food may sound appealing right now, one tell-tale sign of how healthy it is for you is how you feel an hour later,” he said. “Do you feel sleepy or energized? Do you need another sugar or saturated?”
What’s important, Dr. Davies emphasized, is that “if you listen carefully, your body will signal what it needs.”
“Sugar-sweetened beverages are the single largest source of added sugar in the diet,” Dr. Davies said. “A great start to reducing added sugar is to replace soda and energy drinks with water or unsweetened sodas.
And if patients say healthy eating is too expensive, you can remind them that plain water is much cheaper than soda, he added, noting that “if sugar-filled desserts are your typical wage, a good strategy is to get a piece of fruit for sweetening.”
“Even if the temptation to cake or cookies remains, you will probably eat a lot less after starting with fruits,” Dr. Davies said.
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When it comes to choosing what to eat, again, try to focus on “foods that don’t have — or need — labels,” Dr. Davies said. Include “fruits, vegetables, beans and whole grains”.
“If you add foods from animal sources, look for better options like healthily prepared fish and unsweetened yogurt,” he said, adding that it’s also important to avoid certain foods like “key triggers,” which are “sugar-sweetened beverages,” processed meats and fried foods. “
“With the Mediterranean lifestyle, part of it is food choices that include fruits, vegetables, nuts, lean proteins and olive oil – they are generally good foods,” Dr. Lazarus said, adding that it is important to avoid highly processed foods.
“The problem is that people crave highly processed foods when they’re stressed,” he added. “And they’re usually as crunchy as potato chips or, more commonly, I see ice cream and peanut butter usually in the evening.”
One piece of advice, Dr. Lazarus said, is to prep or prep healthy snacks because “if you’re reaching for something because you crave things, you’re reaching for something healthy.”
The COVID-19 pandemic has caused a significant increase in stress for many people. And when stress does happen, eating healthy and getting a good night’s sleep goes out the window. But the key step to eating better is getting a good sleep schedule.
“A good eating schedule begins with your sleep schedule,” Dr. Lazarus explained. That’s because “their sleep is one of the first things to break when people are stressed. It’s like they’re tired, but they can’t sleep, they have insomnia and then they wake up and they’re tired and then they’re stressed – it’s a self-sustaining cycle.”
“A lot of the times I like to start, I try to go to bed at the same time, try to get up at the same time and get a reasonable number of hours of sleep,” he added. “This way you will have enough energy to get through the day.”
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Carbohydrates, fats, and proteins are all macronutrients, and they are the building blocks of the food we need in relatively large amounts. But how do you know how much to choose from each one?
“It is not possible to generalize about an ideal distribution of macronutrients as individual needs will vary based on medical history, life stage and activity level,” said Dr. Davies. “It’s interesting to note that the protein content has become a huge selling point on food labels, but most Americans actually get more protein than they need.
He added, “For fats and carbohydrates, quality is more important than quantity,” noting that “avocados and French fries are both high in fat, but they have distinctly different effects on health.”
“The same goes for carbs — quality matters,” Dr. Davies said, adding, “Think blueberries versus candy.”
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Micronutrients required in smaller quantities include minerals and vitamins.
“There is no need for most people to focus on micronutrients,” Dr. Davies said. This is because “a daily diet that includes a variety of colorful vegetables and fruits, whole grains, legumes and healthy sources of protein will automatically check the required micronutrient boxes.
“One exception is that individuals who do not consume any animal products generally need a B12 supplement,” he added.
The Continuing Medical Education Unit, “Dietology for Health and Longevity: What Every Doctor Needs to Know”, is an AMA-designated subject for a maximum of 4 months. AMA PRA Category 1 Credit™, It helps clinicians start an effective nutrition conversation with patients. The four-hour, self-paced course was developed and hosted by the Gables Institute for Integrative Cardiology, a nonprofit organization focused on enhancing the role of nutrition and lifestyle in health care.
The course includes four modules distributed in collaboration with the AMA Ed Hub™, an online platform with high-quality CME/MOC from many trusted sources to support lifelong learning for clinicians and other medical professionals. With topics relevant to you—including several CME modules on physician burnout—the AMA Ed Hub also provides an easy, streamlined way to find, take, and track educational activities in one place, with automatic CME/MOC credit reporting for some state and specialty boards. AMA members are eligible for a 20% discount. Call (800) 262-3211 or email [email protected] To get a discount code.
Learn more about AMA CME accreditation.