The Importance of Avocados, Olive Oil, and Peanut Butter

Today I’m talking about fats, one of the macronutrients. Protein, fat, and carbohydrate are the three major macronutrients in the diet. Water is sometimes included as a fourth macronutrient.

But first, I’d like to begin with a few words on carbs: The term carbohydrates refers to carbohydrate that comes from a plant that grows in the soil. Whether leaf or fruit or root or stem, this kind of carbohydrate is always, always rich in fiber and phytonutrients. Except for milk and honey, carbohydrate doesn’t really exist in nature without the fiber. This means that whenever you come across carbohydrate without fiber attached, humans probably made it that way. But we don’t call whole, or fiber-rich, carbohydrates “healthy carbohydrates.” In a blog about good health and nutrition, you can assume that I’m always talking about the healthy kind. And while it is true that we, as a society, are drowning in stripped, “unhealthy,” carbs, people do not feel the need to keep reminding themselves. 

So why the term “healthy fats?” I can think of a couple of reasons. The first one is that we have been influenced by the advertising and manufactured-calories industries to be suspicious of the fat in a nourishing diet. We have been told, over and over, that if you eat fat you’ll get fat. And we have internalized this message so successfully that people can sometimes be seen to wrinkle their noses or even stick out their tongues on hearing the word “fat.”

Yet it turns out that this message does not serve us well. Once upon a time, before the development of insulin, a high-fat diet was the only treatment available for diabetes. As a young physician, I noticed that the less fat my patients ate, and the more stripped carbohydrate they were taught to substitute, the more overweight they became. When I shared my observations with them, they were dumbfounded. America does truly have an enormous weight problem. But it’s not because of fat as a general category. If I were going to be more specific, I’d say it’s because of the large amounts of industrially modified fat that Americans are eating.

When I first began to practice medicine in the mid 1990s, fats were still being vilified, and people were still being encouraged to limit their fat intake as much as possible. This many years later, we have come to understand that certain fats are particularly nourishing, and we now encourage patients to eat foods like olives and olive oil, avocados, nuts and nut butters, seeds (e.g., sunflower, chia, flax, hemp), peanuts, tahini, salmon, and deep-sea fish. There may be more, and I am going to predict that this list will continue to lengthen as our understanding expands, but for now these are ones that most of us can agree on. 

The fats to avoid are those that were invented in the twentieth century. Those are manufactured calories. Manufactured calories are not food and they do not nourish you.

In order to distinguish nourishing fats from the fats that were invented in the 20th century, and which were not previously a part of the human diet, we began to call nourishing fats “healthy,” as if the fats themselves are healthy. But they’re not. They are chemical compounds that break down into various fatty acids of various configurations that happen to serve one or another of the beneficial purposes for which we consume them. 

Do we finally know everything we need to know, everything we’re ever going to need to know, about nutrition and fats? It would be premature to think so. But there are some important conclusions on which we can all agree. And one of them is that nourishing fats play an important role in our diets.


Is That Soup Healthy? Or is it Nourishing?

Today I’d like to talk about just one thing, and that is the difference between healthy and nourishing. In 2017, Michael Ruhlman, the noted chef and writer, published a book called Grocery*, in which he reflected on a great many aspects of supermarkets and grocery stores. As part of his endeavor, he asked me to meet with him and share my perspective. Continue reading


My Favorite Topic: Real Food

Almost all diets have one particular strategy in common, which is to increase the amount of real food that people are eating while simultaneously decreasing the amount of manufactured calories, including both stripped carbohydrates and the ultraprocessed oils invented in the 20th century.

Stripped carbohydrates are processed to remove the most nourishing parts, including the bran and germ. Other stripped carbohydrates include white rice, corn starch, corn syrup, and sugar. It is not a coincidence that white flour, corn starch and powdered sugar look exactly the same. We’ve removed the original identities of these products, so all that is left is a pile of white powder. Continue reading


Strategies for Improving Your Blood Sugars

This week I’d like to talk about the concept of diet-controlled diabetes. Sometimes, when a patient’s most recent bloodwork demonstrates a mild elevation in their blood sugars, their doctor offers them an opportunity to try to improve their sugars without medication. If the patient is able to bring their blood sugars into the normal range through changes in the way they eat, perhaps along with increasing their activity levels to some extent, the doctor diagnoses this patient with what they term “diet-controlled diabetes.”  Continue reading


Food for Thought

I once saw a post that said “Eat organic food, or, as your grandparents called it, food.” Only a century ago, nourishing food did not require prefixes like real, whole-grain, pastured, free-range, wild, or grass-fed. That’s what food was. What is happening to the food supply? As you have probably surmised by now, I spend lots of time thinking about the differences between real food and manufactured calories.

One strategy I use is to avoid products invented in the 20th century, like cottonseed oil, or high-fructose corn syrup. Also, I stay away from products that tell me when to use them, like breakfast cereals, lunch meats, and TV dinners. No one needs to tell you when to eat a banana, or scrambled eggs, or oatmeal, or guacamole, or chicken noodle soup. Continue reading


Returning to the Beginning: Two Core Messages

Today I want to focus on two of the core messages to which I continue to return time and time again: First, there is an enormous difference between real food and manufactured calories. And, second, as we have been discussing at length in recent weeks, manufactured calories have been associated with an epidemic of chronic diseases, including not only diabetes, coronary artery disease, and obesity, but also depression, dementia, and other brain diseases. Continue reading