I was having a conversation with my friend Howard the other day. He’s a doc, too, and we enjoy talking together about practicing medicine, taking care of patients, what it’s like, what we learn from it, and how we can do better. I am very grateful for Howard, and for the fact that we have been having this conversation for almost 25 years.

I am engaged in a never-ending quest to better understand exactly what I do each day, and exactly how I am doing it. I feel that the more precisely I can say what it is I do, the better I can do it. I want patients to remain healthy; I want them not to become diabetic. I want to give them the tools to guarantee, to the greatest extent, this outcome.

I came up with this: “I show people what their actual choices are, and then I explain the consequences of those choices.”

Howard said, “It’s not simple; but it is basic.”

It’s as basic as it could possibly be. The American diet makes people sick. It causes diabetes, obesity, and all their consequences, including arthritis, stroke, and coronary artery disease. If you don’t like those options, which of course you don’t, you’ll want to skip the white flour, manufactured fats and sugar. That’s the basic message.

But Howard is right; it’s not simple. Not when most everyone you know eats the American diet. Not when you get most of your nutritional information from the processed food industry. Not when it’s the only way you’ve ever known. Not when it’s how your mother fed you when you were growing up, and how you learned to feed your own family once it was your turn. It’s not simple at all.

I continue my quest. Implementation may never be simple, but perhaps the message can: Eat fruits, vegetables, beans, whole grains. Nutritious fats. High-quality protein.