Tag Archives: diet


dreamstime_l_3003410I’ve always been interested in the basis for understand how ‘we know’ things that we know.  As a result of this, I became a philosophy major at Arizona State, and although I focused most intently on the Platonic Dialogues, and the Philsophy of Science, Epistimology (theories of knowledge) was an area of fascination.

How do we know that the earth is round?  I believe it…I’m sure you do, and perhaps I could give you some arguments to prove my case, but much of what we believe turns out to be based on commonly held wisdom that has been proven true by scientists, or explorers, or some other person, and then become among the general knowledge that we all carry around with us.

In medicine, there are lots of popular thoughts about different topics that are just plain ‘false’, but due to popular acceptance, they are perpetuated as true, despite little basis or proof or even when there is a great deal of data to the contrary.  It is hard so shake a popular held belief.  Even when I say them to my close friends and family, and swear that it’s true, they will no believe me as it is so ingrained in popular mythology.

What are some of these ideas?  Below are just a few instances of beliefs about specific chemicals that we ingest, and how they affect us, despite little of no evidence.

1.  MSG (Monosodium Glutamate) is bad for you and causes people to get sick

Not true.  MSG has a fascinating history, developed in Japan with the discovery of UMAMI, the ‘savory’ flavor of taste.   It is safe to use and other than it’s sodium (salt content) does not cause issues with health.  You can read this Wikipedia article to read some unbiased information on the topic.

2.  Sulfites are common in wines (and are not found in other food items).  This wine preservative causes headaches in many people.

Not true.  There is very little evidence that it is Sulfites that cause issues with drinkers, it is more the alcohol content or dehydration that lead to trouble.   Read this article from the Wall Street Journal, that was recently written on the topic.

3.  Gluten sensitivity is common and causes a variety of symptoms that bother most people’s digestion.  It should be avoided.

False.  Gluten is a protein found in wheat.  When I was in medical school, we learned about Celiac Disease, an immune disorder of the small intestine that is 100% caused by gluten in the diet, but there is no evidence that gluten sensitivity exists to any major degree outside of this small group of patients with true Celiac Disease.  Sure,  eating a lot of grains and starches may not be the best food choice for most people, and they may notice improved digestion when they avoid such substances, but there is no scientific evidence that gluten itself is causing major issues for people’s health or digestion.  Despite this, the food industry is using this perception to help sell a whole host of products.  Read more about this topic in these two articles from SLATE MAGAZINE>>>








200px-Willie_KeelerWee Willie Keeler of the Baltimore Orioles had it right…..when he said to ‘Hit’em where they ain’t’; and now the official advice from the US Department of Health is that cholesterol in the diet is not a problem.

Don’t get confused….cholesterol is still a concern, it’s just that most cholesterol (80+%) is made by your body, not ingested in foods. This means that egg yolks, and shellfish, which have gotten a bad rap for a lot of years due to the high amount of cholesterol they contain, are off the ‘NO EAT’ zone and can be consumed without concern.  The amount that external cholesterol ingestion contributes to your cholesterol levels is modest, and thus there is no reason to avoid these foods.

But don’t mistake this recommendation with the thought that cholesterol is not considered a contributor to heart disease….it is.  It’s just that the amount you get from exogenous sources is modest and need not be modified.

This is similar to salt in the diet.  I have patients tell me all the time….”I never use the salt shaker….so don’t worry about my salt intake.”     But the salt shaker only accounts for about 12% of your salt intake in the day.  Salt is hidden in all packaged and cooked foods and that is where we find the vast majority of our salt.  So…..our foods are ‘hitting them where they ain’t’…and we need to be smart and understand how these food factors come to play a role in our long-term health.


apple cutI think I’m like most people….in that I have a feeling about most of the foods I eat.   What I mean by that is not….oh, this is tasty….but rather that I have a feeling about whether I’m eating healthy or not.  If I eat a burger….I feel like ‘that’s not good for me’, while if I eat some oatmeal….I feel…”I’m being healthy.”

Our relationship with food is a curious one, and to be honest, I suspect most people in the U.S. have issues with their food choices much of the time.

With this in mind, the latest research that is returning fat and meat to the diet, as healthy choices, is both reassuring and a bit concerning.

Reassuring, for me, as a meat-eater…..giving me cover and making me feel ‘not so bad’ about the choices I make, but disconcerting in that it calls into question all of what we have been told by ‘the experts’ over the past few decades.

Books like Salt, Sugar, Fat....which was popular last summer, and which I commented on previously here in my blog, showed the issues with processed food.   Now, the upcoming book   that looks at meat and fat…. “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet,”  and reasserts that these are healthy and good to resume in our diets.

Why we have changed our minds on these topics, is elucidated in this article from the Wall Street Journal, but I think that the best advice for your diet, came from Aristotle, the great Greek Philosophy.  To shoot for ‘the golden mean’ and to find balance in all things, diet included.

See more on diet, here in my video about Ancel Keys and the Mediteranean Diet.




dreamstime_l_5740056That simple admonition, best captures my sense of the ‘science’ of diet and how to eat properly for your health.    There are advocates for every  type of diet….low calorie, low fat, low sugar.  All have their advocates and their detractors, and all have some supportive research as backing, but there will be NO definitive answer to this question.

A recent study cited in the NY Times was brought to my attention by a patient, and this study showed that saturated fats, long the villian of the American diet, have now been given some cover.    In a article in the ANNALS OF INTERNAL MEDICINE  >>>HERE<<<   did not find an association between heart disease and saturated fat consumption, nor did they find a reduced level of heart disease in those who has unsaturated or monounsaturated fats.

While this is good news for those of use who like our burgers, it just shows that the complex connection between diet and health is so multifaceted, that eating with moderation, both those items claimed to be ‘healthy’ and those unhealthy, will likely yield a fine, and long life.   Keep your processed foods to a minimum, eat appropriate portions, exercise (don’t forget that….#1 KEYS recommendation), and keep your weight from ballooning and you’ll stay healthy.



cool microphonesAs most of you know, I am a fan of fat and protein in the diet at the expense of starches.  Atkins Diet and Paleo seem more in-tune with our evolution than the modern grain-focused fare.

This NPR piece on regular milk helping maintain proper weight, as opposed to skim milk, is another piece in that puzzle.  Although we are can argue about the benefits of milk later in life, the move to skim milk can have the contrary effect of enhancing weight gain, despite it’s lower calorie count.



Do you have a recommended daily target level for carbs that I can use as a guideline while trying to reduce them?



I asked my friend, Debbie Landau-West, for your comments.  Here is the reply from Debbie Landau-West, a nutritionist and dietitian I’ve known for 30 years, and who is the expert in nutrition in Scottsdale.

“It varies greatly but for an older individual with moderate activity 100 grams to 120 grams daily.  I have gone as low as 60 but that is more atypical.”  Deb


NEWS78More Olive Oil Please!

A new report in the NEJM (New England Journal of Medicine), out of Spain, demonstrates great heart advantage to the Mediteranean diet.  A 30% reduction in risk for heart attack was noted, for patients eating 1 liter of olive oil per week, along with additions of good oils from nuts (1 oz. per day).

We will be exploring this topic in April, with Debbie Landau West, when we look at the practical implementation of a Mediteranean diet in your life.



cookie chocolate chipReducing carbohydrates (sugars) in the diet, is a major theme among many nutritionists and dietitians, particularly in an effort to reduce our reliance on carbohydrates for our calories.  In so doing, the hope is that we will reduce obesity and overweight.  In particular, white bread is considered ‘verboten’ as it is so highly refined, that it has a Glycemic Index is 70! (This means that eating white bread, your body gets more sugar, more quickly, than eating sugar itself!  Hard to believe…but true.)



So, as an alternative, we are told to shy away from refined grains and try whole grains instead.  The benefit is that they contain the necessary vitamins and minerals that are removed from the refined white bread, and that that absorb in our bodies slower (have a lower Glycemic Index) and thus have less negative consequences on our metabolism (meaning….they cause less insulin effect.)

The explanation for why whole grains don’t appeal to us, like white bread, is being evaluated by food scientists, and there  is an interesting article on NPR that explains just why we can’t bring ourselves to ‘love’ whole grains as naturally as we love white bread.

Read about it here:



That was Jackie Gleason’s tag line…and it could substitute for the controversy these days in the Department of Agriculture.  Just as the controversy over sugar consumption is heating up, the Dept. of Ag now claims their estimates of sugar consumption are 20% lower than previously stated.

There are a variety of reasons for the adjustment, and to read more, check out the NY TImes article



Perhaps this adjustment is meant to ‘cover’ for consumer products manufacturers, to help them out with the controversies arising lately in New York City about large sugary sodas, etc….

The estimates for sugar consumption have always been suspect and varying, depending on the methods used for calculation.  Estimates range from 160 pounds per person per year to now the new adjustment to 80 pounds per person per year.  One thing is for certain….we eat a lot more sugar than we did in the past.

In 1900 we ate 1/2 as much sugar as we do today, and in 1800 we ate probably only 10%.  This is an amazing increase.  To understand more about sugar in our history and society, check out my video:



I must talk to 20 people a day about eating better and losing weight. It is so difficult and there are so many different ways to lose weight.
Trying to just improve our diet is a great first step and making some simple changes will give us improved health if not the weight we desire.
Check out these resources. One is from Hopkins:

On another front, there is an exceptionally appealing website paid for by YOUR TAX DOLLARS. Yes….try to get something back, by checking out this website of dietary information