27 December 2017: Food: The Good, The Bad and The Ugly

Food: The Good, The Bad and The Ugly

or Stop Eating Empty Calories

By Nat Pernick, M.D.

27 December 2017

This time of year we focus much of our time and energy on eating, so it is important to think about what we are eating and how it affects our health. All food is not created equal. In my recent paper, How Cancer Arises Based on Complexity Theory, I describe the Western diet (high fat, low fiber, low consumption of vegetables and fruit) as one of nine “chronic pressures” that cause most cancer cases. With apologies to Sergio Leone, in this paper I divide food into The Good, The Bad and The Ugly.

Most Americans can now easily get enough calories with all required nutritional components through a balanced diet. High quality food, not contaminated by microorganisms, parasites or toxins, is relatively inexpensive and available 24/7. Thus, we need not worry about eating to survive. Instead we should focus on eating to maximize our health.

The “good” foods are not controversial: vegetables, fruit and whole grains. This is the recommendation of US governmental agencies (Health and Human Services, USDA), the American Cancer Society and the American Heart Association. Each meal should be centered on eating vegetables, fruit and whole grains - they should not be an afterthought. This is a complete reversal of how we were taught to eat, in which protein must dominate a meal, and then we throw in some vegetables and fruit. It necessitates a major shift in our thinking and behavior that will require time to implement but is important for our optimal health.

Some foods are “bad” because they are simply empty calories. They don’t provide the anti-cancer, anti-heart disease factors found in vegetables, fruit and whole grains. Most people are obsessed with protein; their meals must be centered around meat, poultry, fish, eggs or dairy. But as the American Heart Association notes, “You don't need to eat foods from animals to have enough protein in your diet. Plant proteins alone can provide enough of the essential and non-essential amino acids, as long as sources of dietary protein are varied and caloric intake is high enough to meet energy needs.”

Foods are “ugly” that statistically have been found to contribute to cancer, heart disease or other serious diseases. They include foods high in fat, sugar, refined grains or that are highly processed. Many of these ugly foods are considered to be “proinflammatory” according to The University of South Carolina Cancer Prevention and Control Program, which developed the dietary inflammatory index (Shivappa 2014a). A proinflammatory diet is associated with a higher death rate due primarily to digestive cancer, cardiovascular disease and chronic obstructive pulmonary disease. Food groups associated in one study with the highest inflammatory index were butter, beer, coffee, fried food, liquor, high sugar beverages and french fries; those with the lowest inflammatory index were vegetables other than potatoes, low fat dairy, fish, fruit (not juice) and nuts (see Table 2).

Eating healthy is a continuous process of behavior change that takes years to optimize. We should choose more healthy foods, limit empty calories, stop eating when 70% full, resign from the “clean plate” club, avoid processed food, not eat for psychologic reasons, avoid unhealthy food even if easily available and monitor our caloric intake to maintain a body mass index (BMI) of 18.5 to 24.9.

Let’s start today!