By now you've heard of every diet trend, from paleo to anti-inflammatory, to keto and carnivore, vegan, "plant-based" and everything in between. With so much information out there, it's hard to know what is the best diet for human beings in order to promote health and longevity.
Let's start with this: to me a healthy diet means it allows you to get all the essential nutrients the body needs to function optimally on a daily basis, it helps you to maintain a healthy body weight, it helps you feel your best, and it is not so extreme that it's hard to do. Also, a healthy diet should allow you to maintain normal blood sugar levels throughout the day and night, and consequentially, not develop high insulin levels followed by insulin resistance which we now know goes hand in hand with weight gain and obesity, as well as metabolic syndrome and Type 2 diabetes (reference my previous blog post on this topic here: )
With all this said, my personal opinion is that there isn't a "best" diet or "one-size-fits-all" eating plan that works for all people. However, I will give you some pearls and tips here to help you decide for yourself what might work best for you. Keep in mind that science is forever evolving, and what we believe to be best today, could change tomorrow based on new evidence; however we have a pretty decent evidence-based approach at the current time to help guide us.
I think the best diet for you is one that works with your lifestyle, and addresses any current health concerns. Here's an example: if you're into weight lifting and body building, you'll need a diet that includes protein in each meal so that you can build that muscle. But, you still need to include healthy sources of carbohydrates to give you fuel for your work outs.
Let's say you suffer from an inflammatory condition or an autoimmune disease (e.g. rheumatoid arthritis, psoriasis, inflammatory bowel disease, eczema, multiple sclerosis). In fact, many diseases have been linked to chronic inflammation (such as cancer, Alzheimer's disease, heart disease, arthritis, and depression). In this case, an anti-inflammatory diet (e.g. the AIP diet is one variation) may be helpful to you, and it certainly will not hurt. I like this diet because it emphasizes nutrient-dense food that is not processed and I think we can all benefit from that. In addition, we have good evidence to suggest that inflammation is involved in the aging process, so it certainly could benefit us to eat fewer "inflammatory" foods (highly processed foods, sugary foods, trans-fats, etc.). Foods that may increase inflammation in the body include refined carbohydrates (like white bread and pastries), fried foods, sugary beverages, processed meat (like sausages, hot dogs, and lunch meat), margarine, shortening and lard. Foods that may help reduce inflammation are rich in polyphenols and antioxidants, and include extra-virgin olive oil, green leafy vegetables, fatty fish (like salmon, mackerel, tuna and sardines), nuts (like almonds and walnuts), and fruits like blueberries, strawberries, cherries, and oranges.
What if you are overweight, and have been told you're "pre-diabetic"? This is a big red flag that should stop you in your tracks. It means that you need to alter both your diet and your activity level to help prevent you from progressing to full on diabetes, and all the complications that can be linked to it (like heart disease, kidney disease, poor wound healing, etc.). Here's the thing that medical providers don't always tell you: prediabetes and type 2 diabetes are both reversible with lifestyle modifications. Your diet should be modified so that you avoid sugary drinks, refined carbohydrates, and "snack food" which is mainly highly-processed and inflammatory, while often containing hidden sources of sugar like high-fructose corn syrup. You will want to focus on eating some protein with each meal, a small amount of healthy fat (like extra-virgin olive oil, avocado, and nuts) and healthier carbohydrates that have a low-glycemic index (meaning they don't tend to cause large spikes in the blood sugar level). This type of balanced meal will help you feel less hungry, and avoid having as many cravings for sweets and snacks in between meals. Focus on eating real food, not processed foods. Try to get as much color on your plate as you can, as this will help you consume more vegetables and fruits, which we know also have a beneficial effect on your digestion and your gut microbiome (having healthy gut bacteria may help you to stave off diabetes and weight gain).
What about the Mediterranean diet? This diet based on the style of eating in the Mediterranean region is rich in vegetables, fruits, whole grains, legumes, healthy fats like extra-virgin olive oil (EVOO), nuts, fatty fish (for the Omega-3 fatty acids) and lean protein like chicken; it limits red meat, and allows a moderate amount of wine if you already drink wine. (Love that 80/20 rule!!). A moderate amount of wine means one glass per day for women, and two glasses per day for men. It tends to be one of the preferred diets for lowering cardiovascular disease risk and improving longevity. This diet can also be modified easily to be vegetarian or gluten-free. This is my personal favorite for people who are just looking to have healthier eating habits and cut down on consumption of processed foods. I think it's pretty easy to follow, and not overly restrictive like some diets can be.
Have you heard of the paleo diet? I like this one too, as it also tends to focus on eating "real food" and not processed junk food. The concept behind the paleo diet is that it is based on what foods humans would have eaten during the paleolithic era. It includes many lean meats, healthy fats, fruits, nuts, and eggs. It excludes grains, legumes, dairy products, refined and added sugar, and highly processed foods. I find it to be very reasonable, and may require a little bit of meal planning or prepping to make sure to avoid those hidden sugars and dairy that can be found in commercially prepared foods.
I would be remiss if I failed to mention the keto diet (or ketogenic diet). This eating plan became super trendy several years ago for the purpose of weight loss, and has held it's own in the world of diet trends. The keto diet focuses on getting the majority of calories from fat. It is a very low-carb diet, and as such, limits the amount of fruits and vegetables once can consume in a day. The idea behind a diet that is very low in carbohydrates, is that it can force the body to use an alternate source of fuel, that being ketone bodies, which the liver produces from stored fat. While many people have sworn by this diet for weight loss, I personally don't think it's ideal as a long-term eating plan. In particular, the lower intake of fruits, vegetables, and grains means your good gut bacteria is not being fed as well, and you may also be prone to constipation on this diet. Additionally, you miss out on the nutrients and antioxidants found in plant-derived foods. And since antioxidants are key in promoting healthy skin, cardiovascular and brain health, this one isn't my fav of the eating plans.
Let's not forget our vegetarian and vegan diets. Both being plant-based, but with vegan being the more restrictive diet by eliminating all animal-derived foods like dairy, eggs, and butter. In the past there was a lot of banter about how these diets didn't provide enough protein or Vitamin B12; but today our knowledge about nutrition is good enough that some simple guidelines for vegans and vegetarians can help them ensure they are getting all the necessary nutrients from their diet. The benefit of these plant-based diets is that they should provide plenty of prebiotic foods, i.e. foods that help feed our good gut bacteria; plus they may help lower the LDL-cholesterol when processed foods are avoided. There's been a lot of media attention lately directed at supporting or negating the benefits of eating a plant-based diet (reference movies made about this topicon Netflix, and even elite athletes that follow this eating plan). My take on it is this: whenever a person or industry has a lot to say about a topic (good or bad), they may have a financial interest in voicing their opinions. In other words, the media shouldn't be your guide on what is going to work best for you and your health. And yes, people can be very healthy while eating a balanced vegetarian or vegan diet.
Nothing is all good or all bad. But one thing that is clear, is that we need to focus on eating less processed food and more "real food". The commodity of food that is fast and convenient has done us a disservice when it comes to our health. There isn't one diet that is best for all people. It depends on their preferences, their specific health conditions, and what makes them feel best in terms of energy, gut health, mental clarity, and any ethical or religious considerations. My personal favorite eating style is the Mediterranean diet, as it has been studied and shown to lower cardiovascular disease risk, a leading cause of death in many countries. And since vascular inflammation has also been linked to accelerated aging, I see an added benefit of this diet from an anti-aging standpoint.
That said here are my pearls for better nutrition and maintaining a healthy body weight without being so restrictive that you set yourself up for failure:
Rather than focusing on foods you "can't have", focus on the "superfoods" you can have, that have nutritional benefits. Try to include some of these foods in each meal. Examples of what I consider "superfoods" are: EVOO (extra-virgin olive oil), lean sources of protein (lean meats or plant-based; avoid fatty fried foods and processed meats like hot dogs and sausages), berries (blueberries, raspberries, strawberries), tart cherries, nuts (walnuts, almonds, and hazelnuts), dark leafy green vegetables (spinach, kale, swiss chard), avocado (a good source of healthy fat), and if you enjoy coffee or dark chocolate, these can also provide some beneficial antioxidants in your diet :).
Remember your eating style is a lifestyle choice, not a 30-day crash diet. It needs to be something you can adopt for the long term.
If you have been told you're prediabetic, consider this a red flag that means it's time to make some changes that can help you to reverse this condition. You are not powerless and can change this. You may need the help of a trusted physician and/or a dietitian to help you get started on your new eating plan and exercise program.
The best diet is one that you can follow long-term, with the goal of feeling better, improving your health, and increasing your longevity. There is more than one way to do this.
Remember the 80/20 rule- don't hold yourself to unobtainable standards. We all indulge once in a while.
Wishing you a happy, healthy week and many more to follow.
Cheers,
Dr. B
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