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


Can I Eat Fruit?

On many occasions, patients have asked me whether it’s okay to eat fruit. They’re worried about whether they should eat a food that they know is rich in sugar. Let’s think about this for a minute. Does anyone really believe that fruit is what’s causing the epidemics of diabetes and obesity? You can rest assured that the obesity and diabetes epidemics are not being caused by fruit. I think of fruit as “nature’s candy” and while it’s true that some fruits contain a lot of sugar, it is always accompanied by a large amount of fiber. Continue reading


Eating Slowly

Many years ago my mom and I were spending the day running errands when we suddenly realized that it was already the middle of the afternoon and we hadn’t eaten lunch yet. We were famished. I rummaged around for a snack, but all I could come up with was a tiny cellophane package of jelly beans. While my mom kept her eyes on the road, I tore open the package and divvied up six jellybeans. A very short while later we laughed as we realized that now we were barely hungry at all. Knowing that this was going to be a temporary state, however, we soon pulled in to our favorite diner and ordered lunch.

For me, this experience illustrates an important principle, namely that if you wait a little while after you eat, there is an excellent chance that your hunger will resolve. Continue reading


A New Patient Gets a New Perspective

A few months ago I saw a new patient and she had a good deal in common with many other new patients I see. Even though she knew that her excess weight was doing her no good, and that it raised her risk of many chronic diseases, like breast cancer, for example, and diabetes and high blood pressure and colon cancer, she was unable to do anything about it. She was also really tired of doctors telling her that she should lose weight. Really, really tired. “Tell me something I don’t know,” she said to me. So I did. Continue reading


Every Little Bit Counts

I have some amazing news to share. A recent study published in the journal Diabetes Care observed a reduced risk of diabetes (type 2) in older women who walked just 1000 steps more every day. You can access those findings here. This week’s post might, at first glance, seem a little dry to you, but if you’ll stay with me for a couple of minutes, I think you’ll find an important observation here that may resonate deeply. It’s not about diabetes, or even walking for that matter. It’s about success. Continue reading


Your Health is Where You Want it to Be

Good morning, and happy Sunday! I want to tell you about a conversation I had with a patient this week. She was someone I’d never met before, and, like many before her, she was absolutely flummoxed about what to try next. She had already done everything she could think of to lose weight. I think you know this story. I’ve told it many times before, and you may even have experienced it yourself. Maybe you’ve been on practically every diet, eaten cabbage soup, denied yourself your favorite foods, carved out time you didn’t really have to get more exercise than was comfortable at the time. Of course none of this was sustainable. You can’t eat cabbage soup for breakfast forever. So what’s next? Next comes balance. Continue reading


Is Morning Time the Best Time?

My sister told me the most interesting thing this week. She said that she prefers to prepare vegetables (like broccoli, for example) in the morning, when she has more energy, instead of leaving it to late afternoon, when she, along with the rest of her family, is hungry and running on fumes, as an old friend used to put it. She already buys her broccoli in bags of florets, so that part is done. Then she tosses a few handfuls into a steamer set in a pan containing a few inches of water, sprays them with olive oil, shakes on some salt and pepper plus Trader Joe umami seasoning (mushroom powder, onion powder, spices), and keeps layering until the bag is empty or the pot is full. Then she turns on the water to boil, and pretty soon the broccoli is bright green and ready to refrigerate, to be eaten later that day or the next. Single mom, super efficient. Say no more.

This story got me thinking about something else. Continue reading


How Much Stripped Carb is Safe to Eat?

Today’s post is about how much stripped (refined) carbohydrate is okay to eat.  Stripped carbohydrate means white flour, white rice, corn starch, corn syrup, sugar. Plus fruit juice and beer. Basically, stripped carbs are carbs (mostly grain, though not only) that have had their fiber and color stripped away. It’s not a coincidence that white flour looks exactly like corn starch and powdered sugar. They’ve all had their color and fiber stripped away, and all that’s left is a pile of white powder.

This post is only about stripped carbs. It is not a discussion about whether carbohydrates are okay to eat. There are people who feel that carbohydrate has no place in their diets, and who manage beautifully on a very-low-carbohydrate diet. I get plenty of comments from readers who eat this way. Someday, we may discover that this group of people share a combination of genes that makes it very difficult for them to tolerate even modest amounts of carbohydrate. For now, I am glad that they have figured out how best to protect their health. So this post is not for them. It is for people who tolerate whole grains, fruit, and beans without any problems. People who feel awful if they skip the vegetables, grains, beans, and fruit. Like Dr. Caldwell Esselstyn.

If you look out your window at some growing food, you will notice that there is no such thing–in nature–as carbohydrate without fiber attached. Stripped carbs are relatively recent  inventions. Stripped carbs are derived from raw ingredients — mainly grain and produce (dates and beets) — that are abundant in nature. Human beings figured out how to convert these ingredients to flour and sugar only in the past couple of hundred years or so. We did not evolve to eat these food-like products, and certainly not at the volumes we currently consume them.

How much stripped carbohydrate is it “safe” to eat? Not a lot. But I would not say zero. There’s a certain amount that probably doesn’t matter much, one way or the other. At the end of the day, I think it comes down to a relatively simple equation, one that is probably affected by three things: 1) your genes, which are heavily influenced by your environment, 2) the amount of unmanageable stress you withstand on a daily basis, 3) and the amount of activity in which you engage regularly.  

Stress can be physical, emotional, social, spiritual. It can come from within (fever, anxiety, bereavement, pregnancy) or without (a blizzard, a heat wave, a new baby, winning the lottery). It can be the result of circumstance (a safe falls on your head) or questionable decision-making (skipping breakfast). It can be due to conflict, real or imagined. Agents of stress can be small like a virus, or large like an asteroid. Pain, fatigue, sleep deprivation are serious and common causes of stress.  

And, yes, stress can be caused or exacerbated by eating foods that don’t provide the building blocks your body needs to function optimally. Like stripped carbohydrate. In other words, stress causes stress. That’s one place you do not want to be. So eating more nutritious food, which helps make your brain and body work better, is one way to decrease the amount of stress in your life. 

Are you looking for a number? Okay, here it is. You can have two servings of stripped carbohydrate. But how often, you ask? Well, that depends on you. It could be two servings per day, per week, per month, or even per year. If you are slender, active, comfortable, and quite healthy, you may be able to tolerate as much as two servings a day of stripped carb.

Note that this means not two cans of soda pop, but two ounces. A can of soda with 12 teaspoons of sugar is not one serving. It is 12 servings. Two servings is just one-sixth of a can.

Continue reading


Take Back Your Teaspoon!

Did you know that most sodas are sweetened with a teaspoon of sugar per ounce? That means the average 12-oz. can of soda (pop) contains the equivalent of 12 teaspoons of sugar. Excessive, to say the least. Actually, it causes diabetes and obesity. Not in my cup of tea. When would you ever consider putting 12 teaspoons of sugar in your glass of iced tea? It seems absurd when asked this way, but people are doing it all the time — every time they pop open a can of soda. This week, we’re talking here about the crazy amounts of hidden sugar in processed items. Continue reading