Updated: Feb 23, 2022
As doctors, one of the most common questions we get from patients is: “What should I be eating, Doctor?”
The short answer is that we don’t actually know.
Back in the 80’s when I was in medical school we were taught very little nutrition, and sadly the situation has not changed much since then. I remember mostly learning abstractly about protein deficiency like kwashiorkor and vitamin deficiencies like rickets.
In practice I found that everything was pretty much deferred to Nutritionists to deal with. The problem was that most patients’ insurance doesn’t cover Nutrition consultations unless they have diabetes. And the field of nutrition was about to experience a revolution called the internet.
The democratization of health information has been a double edged sword, allowing the lay public access to scientific findings directly and timely, but that same audience is also then prey to commercially/politically driven “education”, media hype, and misinformation.
But wait, we were taught this simple equation that’s meant to work, right?
Calories in < calories out
And everyone knows that a calorie was a calorie was a calorie, right? Actually these concepts fall woefully short in explaining physiological concepts that we are just beginning to understand as being so, so much more complicated than that.
No one size fits all
The nature of medical research is to assert hypotheses, attempt to prove them through carefully controlled experiments, and then see if others can replicate your results or whether they find evidence to the contrary. Nutrition research has been notorious for contradicting itself, whether backtracking on calcium supplement dosing or recommendations on fat consumption.
We each need to create an eating plan that is a sustainable way of eating for life for us
The bottom line is that while science can give us an idea of where to start, we need to figure out what works for our own bodies through trial and error. It’s like figuring out the best fertilizer for your tomatoes in your climate with the exact conditions pertaining to your vegetable garden - some fertilizers work for most gardens, but no two gardens are exactly alike.
I never recommend specific diets for patients, encourage them instead to each create their own eating plan that will be a sustainable way of eating for life. Having said that, most patients like to have a place to start rather than building from scratch, in which case I will suggest Dr Andrew Weil’s Anti-Inflammatory Diet and Food Pyramid.
The anti-inflammatory diet is based on the Mediterranean diet, which is a plant-based diet rich in vegetables, fruits, and whole grains, health fats, seafood and herbs. The Mediterranean diet has been shown to reduce the risk of cardiovascular disease, diabetes, body mass index (BMI) and inflammation.
Dr Weil has modified this diet slightly by adding whole-soy foods and Asian mushrooms, as well as tea, based on extensive research. He has written a number of books, including a number of cookbooks*, with advice on how to choose and prepare foods that are delicious and appealing to the whole family.
*No commercial interest, just a raving fan.