It can seem like one of the most confusing topics. One can certainly find plenty of conflicting advice out there. Modern Western medicine tends to be very scientifically driven. New medications are authorized for use only after a series of large scale trials. It is much harder to apply this kind of rigorous approach to nutrition since the health effects from the foods we eat can take decades to manifest and are influenced by so many different parameters. To conduct a high-quality study of how diet affects health, researchers would need to closely monitor everything a large number of subjects eats for decades; not the most practical. The best approach may be to look at populations who have low rates of chronic diseases and ask what they eat, don’t eat and how they live their lives in general.

So given the limitations what can modern medicine say about diet and health? Here are a few points that we feel are important when considering dietary choices.

1. Avoid processed foods

Processing food in the most basic sense means changing it. Humans have processed foods for eons: pressing olives to extract oil and grinding grains between stones are some ancient examples. These types of food processing likely don’t contribute in any meaningful way to the chronic diseases we see today like diabetes, obesity and cardiovascular disease. After the industrial revolution many foods could be processed to a far greater extent. Grains could now be ground in large industrial roller mills which would remove the fiber and nutrients. Over the years “food science” has allowed for more and more artificial changes to foods.  Now the term “ultra-processed” is used to describe foods that have been far more altered from their original state than the olive oil and course whole grain flours consumed by our ancestors. Some obvious examples of ultra-processed foods include sodas, potato chips and snack foods. They are typically packaged and have a long shelf life. They usually contain multiple ingredients, many of which may be unfamiliar sounding names that you would not find in your own pantry like “monosodium glutamate” or “high fructose corn syrup”. It can be hard to say definitively how much any individual ingredient harms our health but we can say with certainty that high amounts of ultra-processed foods are linked to many chronic diseases.

2. Replace highly processed foods with “whole foods”

The opposite of processed foods are referred to as “whole foods” and we are not talking about the grocery store here. “Whole” implies that the food hasn’t been altered much from its original state. Fresh fruits and vegetables are the most obvious example.  Another way of passing the whole versus processed foods test is to ask would our ancestors recognize it as food? An apple or carrot would likely be as familiar to Benjamin Franklin as it would to you. An Oreo cookie? Not as much.

When the food industry changes food from its original state it frequently adds three components that are harmful in high concentrations and removes one component that is incredibly helpful to our health. The three added components are salt, sugar and fat (or some synthetic analog of them) which happen to be rare in nature and which our reptilian brains tend to be hardwired to seek out. The incredibly helpful ingredient that is removed is fiber. So that brings us to #3.

3. Eat lots (and lots) of fiber

Most Americans do not eat nearly enough fiber. Fiber has been shown to reduce the risk of heart disease, stroke, diabetes and a long list of other ailments.  The best way to increase fiber consumption is to eat plants that have not been processed much.  Fruits, vegetables, whole grains, legumes like beans and nuts and seeds are the food groups that are high in fiber. It is best to get these foods fresh and without anything added or taken away.

Everyone knows fruits and vegetables are great for your health. But how do you get yourself to eat more of them? Try going to your local farmer’s market regularly. Fresh local produce tastes better so you eat more of it. It’s also fun to get to know your farmers. Take it a step further and sign up for a weekly CSA (Community Supported Agriculture) box. You’ll be forced to try vegetables that you never really considered before and discover what you’ve been missing out on all these years.

Whole grains are an important category of whole foods. Whole wheat bread for example contains all the fiber and nutrients in the original grain-the whole grain is retained, it is just ground into a powder. Refined wheat flour, usually labeled as “unbleached enriched white flour” on the other hand has been processed to eliminate the fiber and nutrients and leave us with the sugary part.  At some point after white flour became popular in the early 20^th century doctors started to notice people were suffering from lack of specific nutrients like B vitamins and folate so these nutrients were artificially added back, hence the term “enriched”. Bread that is made from 100% whole wheat doesn’t need any nutrients added back because they were never removed in the first place.  And that includes the fiber. Other examples of whole grains include oatmeal, rye, brown or wild rice and corn.

When buying products at the grocery store look for the whole grain stamp to know you are getting whole grains.

Legumes are another excellent source of fiber. Researches who study populations with long lives and low levels of chronic diseases, the so called Blue Zones, have found that people routinely consume lots of legumes like beans, lentils and peas. Legumes are high in fiber and protein and so make us feel full for longer. They are inexpensive when purchased in bulk in the dry goods section. When purchased in bulk there is no salt or sugar added unlike many canned versions. Of course buying legumes in bulk requires an overnight soak so some planning is required which brings us to the next point…

4. Healthy foods are almost never convenient and convenient foods are almost never healthy

The best way to ensure no one is pouring salt, sugar and fat into your food and sucking out the fiber and nutrients is to prepare your own meals. The more you can do from scratch the better. It takes time and some planning but in addition to knowing you are doing your body and health a favor making your own meals leads to a sense of satisfaction and accomplishment (especially when it turns out well). Sometimes it seems impossible with a busy schedule but just like exercise, when you make the time to do it you never regret it. Cook with a friend or loved one to cut the work in half and make the experience enjoyable.