What Healthy People Do

Based on abundant scientific evidence (look here for a New York Times article and here for a New England Journal of Medicine article) , we can identify the optimal diet for optimal health. The question for most people is how to fit these eating habits into their already too busy life.     

The optimal diet for optimal health, a diet to prevent heart disease, diabetes, and at least some cancers, is quite simple.  Follow the five steps below and everything else will fall into place.

1. Every day, eat five or more colorful fruits and vegetables, a whole grain or two, and some nuts;
2. Every week, eat a couple servings of ocean fish and a bean dish or two;
3. Make olive oil your primary fat;  
4. Limit red meat and saturated fats; and
5. Avoid foods like pre-packaged, frozen dinners, chips, and energy bars.   

I explain this to patients and they often wonder just how can anyone possibly eat 5 fruits and veggies — let alone  7, 8, or 9. So let me give you a brief review of my diet (both good and bad) for the past week. I was not perfect, but you need to remember that great health does not require perfection, tofu, or spandex.      

Breakfast: Five of seven days I started the day with three cups of coffee, a glass of OJ, a bowl of McCann’s Irish oatmeal topped with raisins and sliced banana or Wheaties mixed with Cheerios topped with blackberries or a banana. One day was OJ, two eggs, bacon, and cinnamon toast and the remaining day was coffee and a pastry (actually two pastries) from my favorite French bakery. On five of the seven days, I had one-plus whole grain and two fruits, a decent start.     

Lunch:  When I am at the hospital, I eat soup or chili and a salad made with dark lettuce and topped with sliced eggs, pickled beets, sunflower seeds, and Ranch dressing. I want olive oil and vinegar, but I have not yet convinced the cafeteria to make this available (give me time). Also note that I avoid the “low-fat salad dressings", because I believe a healthy diet needs the polyunsaturated fat. When not at the hospital, lunch is usually something like shrimp curry, or a ham or tuna sandwich, and once a week maybe a good hamburger. And five of seven days, I eat either an apple or an orange for dessert. The salads count as two  veggies, the orange is another fruit. And, I got a couple of fish (tuna) already.   

Snack time:  Nuts, really good quality cheese, or guacamole.   Sometimes all three in one day. 

Dinner:  For dinner, I really like to cook ocean fish (fast and simple and really good tasting), or I might roast an organic chicken on Sunday and then extend the gravy and add vegetables for a chicken a la king, and then chicken soup (again quick),  or a good home-made meatloaf. We often have two vegetables for dinner or a veggie and sweet potato, rarely white potato. Dessert is a fruit (rhubarb cooked with orange or an apple pie (eat the apples, not the crust).  At the end of the week, just during dinners, I have at least two more ocean fish, and averaged another three veggies and fruits.     

For the week, I had five to seven whole grains, 45 to 50 colorful fruits and veggies, probably five fish servings,  10 servings of nuts, two legumes (beans), limited red meat, cooked only with olive oil and used olive oil on my salads or to dress my veggies.  And no factory-produced, cellophane-wrapped food. Not a bad start.   

We all have failings. Mine is dairy. As a good Wisconsin kid, I abhor skim milk, and love ice cream. Preferably Ben and Jerry’s. My wife just rolls her eyes at me when I eat Ben and Jerry’s out of the pint container. What, a pint is not a single serving size?    

Next week, I post about how I eat in restaurants. Until then, enjoy the healthy food that you eat. Eating a Mediterranean diet will definitely make a positive difference in your health.   

Dr. Bob           

Great health requires three nearly equal components: (1) Genetics and luck, (2) a healthy lifestyle, and (3) good preventive medical care.  You control two and half of these.  

1. Genetics and luck.  
   
   Genetics and luck — for both good and bad — account for no more than a third of our health. And, here's the control part: knowing your family history (the single best and cheapest genetic test around) can lead us to take steps to prevent, stop, or reverse the health effect of the genetic dice. For example, if your father and two paternal uncles had heart attacks in their early 50s, you know you are at risk. But you can use that knowledge to aggressively manage your cardiac risk factors and prevent or even stop your own heart attack.  
   
   
2. A healthy lifestyle.
   
   Many people make the serious mistake of underestimating the tremendous benefit of a healthy lifestyle.  Walking two miles a day can lower your risk of a heart attack by 30 percent, eating a Mediterranean diet can lower your risk of cancer, diabetes, and heart disease, and doing both can lower your risk of type-2 diabetes by 50 percent, and not smoking can lower your risk of lung cancer by 90 percent. Big pharma does not have any pills more powerful than a healthy lifestyle.  
   
   
3. Preventive medical care.
   
   Prevention is very powerful medicine. Primary prevention works to prevent disease by treating risk factors (treating high blood pressure lowers the risks of stroke) while secondary prevention works to prevent the complications after a disease has already been diagnosed (aggressively lowering cholesterols to prevent a second heart attack).  
   
   Unfortunately, our medical system gives short shrift to good primary prevention — a physician and hospital earn more money putting in cardiac stents than in telling people to take their statins, let alone telling people to take a brisk two-mile walk.      
    

But you know  the value of asking about your family history, the tremendous benefit of a brisk walk every day, and the advantage of taking your blood pressure pills every single day. You know you want to be a healthy, active, and vibrant 85-year old.