© 1999 Dr. Dale Peterson; © 2006 Wellness Clubs of America.com

 

Note:  This article was originally published in 1999.  I revisited the subject in the article Healthy Eating Revisited in 2005.

 

“How do you get patients to change their diet?” asked the young physician. I had just presented my philosophy of medicine to her and her fellow residents at a mid-day teaching conference. Lunch had been provided. “I haven’t had any success in getting them to change,” she added.

 

I responded that people who are facing a health challenge are often seeking answers; they are not only willing to change but motivated to do so. The answer was true, but missed the essence of the problem. I asked myself the question again while driving home from the meeting. Why could she not convince her patients to eat an healthier diet? Why do other physicians have the same difficulty? As I thought back to the conference two answers came to mind.

 

I saw the conference setting. I had been offered lunch but had declined. The choices of barbecued chicken, brisket or ribs no longer appealed to me nor did the soft drink selections. The dietary changes that Rosalie and I have made over the years are a way of life now and I could not imagine going back to a “typical American diet.”

 

The first answer became apparent to me. Talking the talk is not the same as walking the walk. How could she, who had just washed down barbecued chicken with a Dr. Pepper out of an aluminum can, speak with authority and conviction about eating a healthy diet. People can detect insincerity. They can spot hypocrisy. People do not follow the advise of those who proclaim, “Do as I say, not as I do!”

 

The second answer to the question, “Why can’t I get patients to change their diet?” is, I believe, found in the syntax. The language of the question infers a doctor-patient relationship. Within the standard medical model, which is based upon the treatment of disease, a doctor-patient relationship inevitably takes shape. In this case the “doctor” almost inevitably takes on a position of authority and strength while the “patient” feels subjected to that authority and operates from a position of weakness. When the doctors actions are incongruent with his or her words, human nature takes its course, and the patient seeks ways to ignore or get around the doctor’s advice.

 

In an health based model there is not so much a doctor-patient relationship as a comradery. We are two individuals trying to die young as late as possible. One may be more knowledgeable or more experienced, but we are both seekers along the way. In this model one is not telling the other, “you must do this,” but rather, “this is what’s helping me, perhaps you’d feel better if you made similar changes in your life.” Empowered with new knowledge the less experienced individual is anxious to make the suggested changes.

 

For years I dealt with the question of diet in the standard manner. I passed out exchange lists, calorie counters, fat gram charts and sample meals. The results were as you might expect…somewhere between disappointing and dismal. I wasn’t surprised. The materials hadn’t worked for me so why should they work for others. Besides, it wasn’t just me; the speakers at continuing medical education sessions regularly reminded me that “people will never eat right or exercise; that’s why we have to use drugs.”

 

Finally, tired of passing out lists that rarely had the desired effect, I developed a set of rules for healthy eating that made sense to me. They were simple. They were logical. They could be applied to any meal in any setting without the use of a food scale or calculator. They worked for me, and I have seen them work for others. This issue of the Health By Design newsletter is devoted to these seven steps to healthy eating.

 

Rule 1:  Keep your diet colorful. I must quickly add that artificial color doesn’t count. Color is provided by fruits and vegetables. Virtually everything else takes on a drab brownish black or white tone. Interestingly, the deeper the color the greater the nutritional value. The lime green limp broccoli boiled to near extinction and placed in a warming pan is a mere shadow of the forest green broccoli at the salad bar or crisp kelly green steamed broccoli complementing the main course of a meal.

 

Fruits and vegetables are higher in nutrients and lower in saturated fat and calories than any other food group. They are also higher in non-nutritive fiber than other foods. Both aspects are important. Plant based nutrients including vitamins, minerals and what are being referred to as “phytochemicals” are being recognized for their ability to protect the body from disease. Dietary fiber is known to play a significant role in preventing constipation and associated conditions such as diverticulosis, hemorroids & colon cancer. It has proven to be useful in improving cholesterol ratios and in improving diabetes. We have nothing to lose (except, perhaps, a few pounds) and much to gain by making our meals more colorful.

 

Rule 2:  Stick to foods that would remain edible at room temperature. This does not mean that foods must be eaten at room temperature, only that they could be eaten at room temperature without hesitation. An example of this is prime-rib. Many people could order a prime-rib special at a restaurant and enjoy the hot, juicy delicacy. Few people would be willing to eat it, let alone enjoy it were the waiter to delay bringing the plate to the table until it had cooled to room temperature and the fat congealed into a yellowish white sludge. This rule is designed to minimize the intake of unhealthy saturated fat.

 

Saturated fat is undesirable for several reasons. First, it is the amount of saturated fat intake rather than cholesterol intake that most influences the total cholesterol level and cholesterol ratios. Secondly, when saturated fat is metabolised, or burned for fuel, in the body a very damaging substance called a lipid peroxy free radical is formed. This must be neutralized by the body’s anti-oxidant defense mechanisms to prevent damage to cells. Finally, saturated fat intake supports the growth of bacteria capable of producing carcinogenic toxins in the large intestine.

 

These effects help to explain why saturated fat intake increases the risk of suffering a heart attack or stroke. They also are responsible for the increase in cancer risk associated with saturated fat intake.

 

Rule 3:  Keep the diet unrefined. There are two aspects to this. The first is to limit the intake of refined (white) sugars and flours. Refined sugars and flours weaken the immune system aggrevating allergy symptoms and making us more susceptible to infections. It is generally accepted that high intakes of refined carbohydrates hasten the onset of Type II Diabetes and make the disease more difficult to control.

 

Whole grains (unrefined grain products) are rich sources of B vitamins, essential fatty acids and other nutrients currently deficient in most individuals. Remember that “enriched” on the label usually means that a large number of nutrients were removed during the processing of the food and only a few added back in. Most “enriched” foods would be better labeled “impoverished”.

 

The second thing to remember is that the long term effects of consuming preservatives and food additives is unknown. Since there has been a significant rise in the incidence of heart disease, cancers, and degenerative diseases as the ingestion of preserved, prepared foods has increased I believe that it is a good policy to place any food which contains ingredients with difficult to pronounce names back on the grocery shelf rather than into the body.

 

Rule 4:  Include vegetable oils. We have become a nation obsessed with eliminating fat from our diet. “Low-fat,” “non-fat,” and “fat-free” labels abound. Avoidance of saturated fat, that is fat that becomes solid at room temperature, is commendable. Unfortunately, the fact that certain fats are beneficial, indeed essential for good health, is largely ignored.

 

Essential fatty acids are necessary for proper body function. Deficiencies of essential fats are associated with dry skin, hair and nails, forgetfulness, joint pain and swelling, frequent colds, abnormal cholesterol ratios, insulin resistance (predisposing to diabetes) and high blood pressure.

 

It has been estimated that the average American is consuming only 10 % of the amount of essential fatty acids required for optimum health. The list of diseases that are in part related to fatty acid deficiencies and which can improve with adequate intake is extensive. It includes, but is not limited to, acne, allergies, arthritis, breast cysts and tenderness, cancer, diabetes, eczema, ischemic heart disease, learning difficulties, psoriasis, schizophrenia and stroke. (Bear in mind that essential fatty acids play a role in, but are not the sole cause or treatment for these conditions.)

 

Rule 5:  Introduce soy products. Soy has long been a staple of oriental diets, but has been ignored in the United States. Exotically named foods such as tofu,tempeh, & miso are not commonly found in American kitchens. Until recently, they were largely sold only through health food stores. At this time, however, Americans are learning about the benefits of soy, and soy based foods are becoming readily available in supermarkets.

 

Substances found in soy, such as isoflavones, are being shown to have benefits in preventing hardening of the arteries, lowering the risk of developing breast, prostate and other cancers, and easing many of the symptoms commonly associated with menopause. The amount of soy protein required to see significant benefit is 20 grams per day. This can easily be accomplished by using soy milk on cereal and having one serving of texturized soy protein each day. Texturized soy protein is being used to reproduce the flavor and texture of popular meats including beef, pork, chicken and turkey.

 

An Oklahoma City Supermarket recently took inventory of the many soy based items available within the store. A five page list of items was compiled including products as varied as pizza, lasagna, burgers, sausage style links and patties, ice cream, cheese, snack bars, shakes, salad dressings, and soy milks. The wide variety of soy based foods now available makes it possible for nearly everyone to find items they enjoy and are able to incorporate into their diet painlessly.

 

Rule 6:  Keep meat portions small.  Animal protein burns to an acidic ash in the body.  Acidic conditions predispose to many degenerative conditions, including cancer.  View beef, pork, & poultry more as flavor-enhancing items than as the "main-course".   Chinese food, which incorporates meats into vegetable dishes is an example of this.  Avoid filling your plate with a 16 ounce steak only leaving room for a few string beans or mashed potatoes on the side.  A 4 ounce serving is considered optimum.  That is a portion the size of a deck of playing cards or the palm of your hand. 

 

Rule 7:  Vary the foods you eat. There are at least two reasons for doing this. Varying the foods we eat gives our body a better chance of accessing the broad range of desirable nutrients. A second reason to vary the foods eaten is that this will significantly reduce food allergy or sensitivity over time.

 

The subject of food allergies has been controversial for many years. This is because most food allergies do not generally present in the same way as air borne allergies. Allergies to pollens, mold, and animal dander are typically related to a rise in a substance called Immunoglobulin E (IGE). These reactions are generally immediate and relatively easy to identify by history or skin tests. While some food allergies are characterized by a rise in IGE, it has been demonstrated that most food allergies occur in response to a rise in Immunoglobulin G (IGG). IGG reactions are delayed and cannot be demonstrated by skin tests.

 

Blood tests are now available to identify both IGE and IGG food allergies. While IGE allergies may develop to infrequently eaten foods such as shellfish, IGG reactions almost always occur in response to foods eaten more than twice a week. The most common food allergens are milk, eggs, wheat & corn. When the offending foods are removed from the diet and other foods varied the body will recover. Interestingly, the offending foods may often be returned to the diet after 3 months without any adverse reactions as long as they are not eaten more than twice weekly.

 

These are rules to remember when seeking a healthy diet: Keep it colorful, edible at room temperature, unrefined and varied. Including whole grains, vegetable oils, and soy products adds the icing to the cake. Oops, I think I just violated one of my basic rules! Perhaps I should add another…Be flexible; enjoy life. It's not the special occasion that does us in, it's the day-to-day routine.

 

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