In talking with patients about how to improve the nutritional value of their meals, we often talk about “real” food.  What is “real” food?  It’s food that has not been processed, refined, stripped, polished, fortified, enriched or otherwise modified.  Basically, we’re talking about fruits, vegetables, legumes, nuts, seeds, grains, fish, eggs, dairy products, and meats, like poultry, beef, and game.  And that’s about it.

Here are two guidelines: The first is not to eat anything that you have to be told is food.  Like what?  Like “processed American cheese food.” Talk about truth in advertising. I mean, if you have to be told that it’s food, it probably isn’t.  On the flip side of this guideline, some products at the supermarket have names that have nothing whatsoever to do with food.  These products are not food; they are food-like products.  Miracle Whip comes to mind.  I don’t know who thought of that name, but it certainly makes me hesitant to swallow.  The same goes for Cool Whip.  These fake food-like products contain a variety of substances that are anything but food.  And these substances aren’t just in food-like products either. Last month I was stunned to discover a fake food-like substance in the ingredient list of a container of brand-name cottage cheese. The offending agent? Food starch. See guideline number one above.

Why is there food starch in cottage cheese?  It’s a cheap way to make cottage cheese thicker.  Thicker seems richer. That’s especially important if the cottage cheese is made from low-fat milk. You will also find plenty of food starch in Cheerios, which has long been touted as a smart and healthy breakfast choice.  It even has a reputation as an ideal snack choice for babies who are learning to feed themselves.

So what’s my beef?  Check the ingredient list.  First on the list is whole oats.  The words ‘whole,’ ‘hale,’‘heal,’ and ‘health’ come from the same root. So far, so good.  Next comes ingredient number two — food starch.  Uh-oh.  Then modified food starch.  Huh? How is “modified food starch” different from “food starch,” a processed food-style product modified from something else?  Though common sense tells you that they are similar,the food manufacturing industry actually differentiates between them.  If they were not listed separately, there would be more food starch than whole oats. It would have to be listed first. That wouldn’t be good for business. Ingredient number four, by the way, is sugar.

Which words have been coopted to make processed,manufactured food-style products more appealing?  Words like “buttery,” “creamy,” or “chocolatey.”  When did we begin to skip butter, cream and chocolate in favor of flavor substitutes that approximate, but never come close to matching, the real thing?  It’s no accident that America’s favorite after-dinner pastime seems to be cruising the kitchen cabinets.  That’s what happens when your body doesn’t get the foods it craves, and the nutrients it needs, in the first place.

Another way to identify real food is to ask yourself if your great-grandparents would have recognized it as food.  Real food hasn’t changed in the past few thousand years or more.  Peanut-butter crackers?  I don’t think so.  But peanut butter?  Yes, absolutely.  Coffee whitener or liquid delights without a speck of dairy?  Never.  But cream? Of course.  I can think of only a few “convenience foods” that don’t make me cringe.  Cheese sticks are good.  Dried fruit, which may be the original convenience food.   Nuts, any and all kinds, just as long as they aren’t coated with some kind of processed food-style product.  Sunflower seeds and pumpkin seeds are good, especially if you are allergic to nuts.  What about artificial sweeteners?  The jury is still out on these, but we do know that people who drink lots of diet soda are at high risk of developing diabetes, just like those who drink lots of conventionally sweetened soda and pop.  So I’m going to reserve judgment until I know more.  Until then, I’d like a glass of unsweetened iced tea, please.  With a slice of lemon, if you have.