There can be many reasons we don’t eat healthy. It’s expensive. The food doesn’t always taste as good as we’d like. It’s restrictive. It’s time-consuming. It’s difficult. I couldn’t agree more, but perhaps the biggest obstacle to healthy eating is defining “healthy.” If you’ve ever tried to define this for yourself, you’ve probably noticed there are many ideologies and diets to sort through. You may have even tried a few diets.
The truth is there’s no universally ideal diet because we all have unique needs. With different genes, predispositions, phenotypes, allergies, intolerances, sensitivities, preferences, medical conditions and goals, it’s not surprising that science has failed to come up with an ideal diet for everyone.
Start with “real food.”What all good diets have in common, though, is “real food.” If you let real food be your guide, things get much simpler.
My definition of real food is “whole foods,” or meals made from scratch with whole-food ingredients. What are whole foods? They’re foods that aren’t processed or refined – or are processed as little as possible – with minimal or no preservatives and additives. You could interpret this as traditional foods or foods your great-grandmother would have eaten.
What is processed food?Most food today is more akin to “edible food-like substances,” as food writer Michael Pollan has put it. The difference between edible food-like substances and real food is the degree of processing.
Food processing usually involves:
• Removal or destruction of fiber
• Use of additives, like sweeteners, salt, emulsifiers, texture modifiers, colors, preservatives and flavor enhancers
• Fortification with isolated fiber, vitamins and minerals
No fiber to regulate nutrientsThe problem with modern food-processing techniques is that the end product contains nutrients that are much more bioavailable, or easily absorbed, than our bodies are prepared for. This is because processed foods contain little, if any, fiber.
Soluble fiber forms a gel that lines our small intestine and slows down the absorption of nutrients. This is very important because it protects us from blood glucose spikes that are too high and occur too quickly.
Insoluble fiber is more like roughage. Think of those stringy fibers in celery. Insoluble fiber forms a structural lattice that speeds up the time it takes for food to reach our colon. Speeding up transit time helps to ensure that our bodies do not absorb some nutrients.
Refined wheat and glucose spikesWhen we eat processed foods, we lose the protection that fiber provides. Take refined wheat, for example. The act of processing a whole food like wheat into a relatively fiberless flour makes the glucose in wheat much more bioavailable to our bodies. What’s left after processing is starch, a long chain of glucose molecules.
Since glucose is the preferred energy source for our bodies, it’s easily absorbed from the gut into the blood stream. But with very little fiber, protein or fat present, there are no barriers to absorption. This means dietary glucose is absorbed quickly and efficiently, resulting in a spike in blood glucose.
Insulin resistance and Type 2 diabetesIt’s quite normal for blood glucose to rise after a meal. The difference between the absorption of real food and processed food, though, is the magnitude and speed with which blood glucose rises. A large, rapid blood glucose spike triggers a large insulin spike. This can lead our bodies to store more fat instead of using it for energy between meals. Translation: weight gain and then an inability to lose it. Blood glucose spikes also can cause increased hunger.
In contrast, a smaller and slower rise in blood glucose, which occurs after eating high-fiber, real food, results in a much smaller release of insulin, less stored fat, more satiety and normal metabolic function.
In the short term, our bodies can buffer against the consequences of large amounts of rapidly absorbed glucose. But over time, our baseline glucose and insulin levels creep up, we may gain excessive weight and insulin resistance may develop. The eventual consequence may be Type 2 diabetes.
Potential harm from added sugarsAnother primary ingredient in processed food is sugar, which can also harm our bodies in excessive amounts. By “sugar” I mean dietary sources like table sugar, high fructose corn syrup, maple syrup and dozens of other added sugars. These sugars are generally extracted from plants through extensive processing techniques.
Sugar differs from starch in that instead of being a long chain of glucose molecules, it’s comprised of one molecule of glucose attached to one molecule of fructose. Glucose from sugar has the same fate as glucose from starch described above. Fructose from sugar, though, is a different story.
When we eat a high-fiber piece of fruit, we absorb small amounts of fructose slowly. The liver has no problem metabolizing it and there is no harm done. But when we consume an added sugar such as table sugar, which has no fiber, we absorb a large amount of fructose quickly. This overwhelms our liver, which converts the fructose to fat.
Fatty liver and high cholesterolThat fat has two possible fates. It’s either deposited in the liver (called visceral fat) or it’s released in the bloodstream as cholesterol and triglycerides. A fatty liver is a damaged liver. One consequence is liver insulin resistance, which also contributes to the development of Type 2 diabetes. A byproduct of this process is the production of uric acid, which can contribute to hypertension and gout.
Simply by examining flour and sugar, the hallmarks of processed food, it’s easy to see how weight gain, insulin resistance, Type 2 diabetes, high cholesterol, high triglycerides and hypertension can develop. These conditions happen to make up America’s largest health care burden at the moment.
Ultra-processed foodsYou may think these conditions develop over decades and you don’t need to worry about them in young children. Historically, that has been true, but our food is changing rapidly. For example, manufacturers today add sugar to 74 percent of packaged foods. It’s in everything from desserts and soda, which you would expect, to bread, meats and condiments, which you probably wouldn’t expect.
Furthermore, a recent study found that 58 percent of our calories come from ultra-processed foods, the worst of the worst. Not surprisingly, ultra-processed foods contain 90 percent of our added sugar consumption.
Ultra-processed foods include soft drinks, packaged baked goods and snacks, many breads, candy and reconstituted meats, such as chicken nuggets.
Considering that most of our calories come from ultra-processed food, it’s no surprise that 55 percent of adults (another majority!) in California are believed to have prediabetes or diabetes.
Children at riskType 2 diabetes used to be called “adult onset diabetes,” but the name was changed as more and more cases appeared in children. The first wave of reported cases in children occurred in the 1990s as our diets became increasingly processed.
Similarly, nonalcoholic fatty liver disease began to appear in children around the same time. A fatty liver is a damaged and insulin-resistant liver. This condition now occurs in 1 in 10 children and is the most common liver abnormality in young people ages 2 to 19.
Focus on whole foodsThe simplest way to protect yourself from chronic, diet-related disease is to avoid processed foods, especially ultra-processed foods. Here are some practical tips to do this with your family.
• Cook at home as much as possible, preferably with whole-food ingredients.
• If you don’t know how to cook or have limited skills, take a class, watch YouTube videos or ask your own parents for pointers. The single best thing you can do for yourself and your family is to cook at home so you can control the quality of your ingredients.
• Teach your children to cook. Engage them in the process so they develop an interest in cooking and the skills they will need once they leave home. Empower them with age-appropriate tasks, like stirring, plucking herbs like cilantro off the stems or making their own school lunches.
• Garden. Perhaps you don’t have a garden plot out back, but you could start with a few herbs in containers.
• When you do buy packaged foods, opt for those that have fewer ingredients, which is an indication of less processing. And consult food labels for hidden added sugar.
• Eat more vegetables in place of grains. A fun way to do this is to make vegetable noodles with a spiralizer or simply use spaghetti squash as a substitute.
• Any time you do eat grains, choose whole grains over refined grains.
• Eat fresh, seasonal whole fruit for dessert.
• Drink only unsweetened beverages.
Nuts, seeds, beans and moreStill at a loss for what to eat? Here are some snacks or small meals ideal for kids and adults alike.
• Banana or apple with peanut butter or almond butter and cinnamon
• Fruit and cheese
• Fruit and plain yogurt with or without chopped nuts and cinnamon
• Half a frozen banana dipped in plain yogurt and rolled in chopped nuts
• Nuts: pistachios, cashews, peanuts, almonds, walnuts, macadamia nuts, etc.
• Spiced pumpkin or sunflower seeds
• Trail mix with nuts, seeds, a few dark-chocolate morsels and no-sugar-added dried fruit
• Hummus with vegetables, such as sliced bell peppers, sugar snap peas, carrots or celery
• White-bean dip with vegetables, such as sliced bell peppers, sugar snap peas, carrots or celery
• Refried beans with cheddar cheese or sour cream and salsa
• Bell pepper nachos with shredded cheese, salsa, sour cream, guacamole and/or beans
• Guacamole with vegetables, such as sliced bell peppers
• Kale chips, preferably homemade
• Ants on a log: celery or banana plus nut butter and raisins
• Cheese and fruit kabobs
• Hard-boiled eggs
• Deviled eggs
• Popcorn with shredded parmesan cheese
• Deli meat (choose high quality with low levels of added sugar, nitrates and sodium, or carve meats yourself) rolled up with a slice of cheese, lettuce and a pickle
• Roasted and seasoned chickpeas
If you have questions about selecting healthy food for your child, ask his or her physician for a referral to Swedish’s pediatric nutrition services.