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 that all that is left is a pile of white powder.

Real food comes in eleven categories. These include fruits, vegetables, beans, whole grains, nuts, seeds, dairy, eggs, meat, fish, and poultry. This is food, and food is what nourishes us.

That does not mean that everyone will eat absolutely everything on the list. Some people have allergies (to nuts or dairy, for example), or particular intolerances (such as lactose or gluten). Then there are those who simply do not eat certain foods, whether for religious reasons, or because they identify as vegetarians (who eat neither meat nor fish) and vegans (who avoid not only all forms of flesh, but also eggs, dairy, and even, sometimes, honey).

So I am not saying you must eat everything from the list of eleven categories. What I am saying is that if you want to nourish yourself, these are your choices. Everything else is entertainment. It’s not that you can’t eat entertaining items; I just you to be aware that they don’t nourish you. They don’t go in the plus category. They’re just for fun. Fun is fine; it’s just not food.

Please don’t think for a minute that I always say no to treats. If I go somewhere and there’s a plate of brownies, for example, there’s a very good chance that I’m going to eat one. Oatmeal-raisin cookies, too, and my husband’s famous banana-chocolate-chip cake.

This entire paradigm is really about personal choice. There are a couple of important questions to ask yourself here:

1. How much entertainment does it require for you not to feel deprived? Know that this will change with time. What you need on the weekends may be less (or more) than what you feel you need to keep yourself charged up during the week. And what you need in 2025 may be very different from what’s on your 2030 list. I’ve been doing this for a very long time, and I can promise you that the way I eat now is very different from the way I ate when I first began this journey. That’s partly because I have come to understand more as time has gone by. And it’s also because I am not the same person I was 25 years ago. And so on. 

2. How well do you want or need to be nourished? Would you consider yourself in good health? Do you have enough energy to be as active as you would like to be? Or have you been struggling with gut trouble, joint issues, chronic low energy or other nonspecific symptoms that you suspect may be related to something you’re eating?  

If you are aiming to improve the nutritional value of your food, I do not recommend making a complete switch all at once. That’s like throwing out the baby with the bath water. Not to mention that it’s probably unsustainable. And any time you set yourself up for failure, you’re setting yourself up for even more failure. The more things you do that make you feel bad, the harder it is to garner the energy to try again.

Instead, pay attention to how much ultraprocessed items you eat for a couple of weeks, and then think about what it would be like to lower it a little bit. Maybe by changing your breakfast from a bowl of “Frosted Crunchies” to leftovers, or a sweet potato with peanut butter (my favorite). Maybe by skipping your afternoon trip to the vending machine for chips, and packing a good portion of almonds and dark chocolate instead.

Don’t focus on calories and portion sizes. Your brain can tell the difference between real food and entertainment. When you eat food that nourishes you, you don’t feel as hungry. Trust how you feel. When your body is telling you something, try to listen. Remember, too, that if, like most Americans, you’ve been eating a diet consisting of a large proportion of ultraprocessed foods, you may need to eat large portions of nourishing food for a long while, perhaps a year or more, to make up for having been under-nourished for years. So to start with, keep your focus on food.

People make all kinds of assumptions about my own diet, so here’s a sample of what I might eat in one day. 

Breakfast: black coffee maybe followed by a bowl of soup and fresh fruit, like berries or citrus. Sometimes leftover salmon and green beans, or whatever else I find in the fridge.

Lunch: I often eat leftovers from the previous night’s dinner, like stew or vegetables. It usually contains some beans, tofu, or fish. Or an avocado, sprinkled with salt, or a bowl of homemade soup and a couple of pieces of fruit. Afternoon snack consists of nuts (any and all kinds), a piece of fruit and a piece of dark chocolate. Before I retired, I used to keep a small knife and cutting board at work for tomatoes and cucumbers, which always taste much better if eaten immediately after slicing.

Dinner: salmon, cod, bean soup, eggs poached in tomato sauce (shakshuka), turkey meatballs, canned tuna. There is always green salad plus one or more vegetables, one of which is always green. Salad can be as simple as lettuce dressed with olive oil and salt, or with sufficient ingredients to constitute an entire meal. There might also be sweet potato, quinoa, kasha, or brown rice. 


Self Care is Being Kind to Yourself, plus Lentil-Vegetable Soup

I spent my days as a practicing physician teaching people to be kinder to themselves, and that kindness manifested itself in three spheres: 1) eating patterns, 2) activity patterns, and 3) rest & relaxation patterns. The goal is to make small, incremental changes that result in nourishing your heart and soul with better food, more movement, and quality rest and relaxation. 

Why do Americans feel as if we must make an excuse for going to bed early, or taking vacation time that we have already earned, or needing to take a walk? I can’t count the number of times I have heard people make fun of themselves for choosing to order a salad. These attitudes, supported (unfortunately) by all kinds of complex societal influences, made my job even more important.

A good life is filled with nourishing food and rest. A peaceful life might include walking, gardening, yoga or swimming. Research shows that time spent out of doors, around trees, is powerful medicine. That’s not surprising to me; I spent a good part of my early adolescence playing in a 600-acre wooded property across the street from my house. 

With regard to our eating patterns, my experience has shown me that most folks think they are doing a more or less reasonable job of feeding themselves and their family, especially if children are involved. 

That makes sense to me, because no one would want to believe that their family is eating a mediocre diet on their watch. We all hope that we are taking good care of ourselves and our families. But how would you know, really?

Do you eat white flour or corn syrup or corn starch or sugar more than once or twice a day? Most people do, because this is where you find breakfast cereals, ketchup, barbecue sauce, commercial salad dressings, bagels, rolls, croutons, muffins, doughnuts, waffles, pancakes, white bread, cookies, cakes, and most other commercial baked goods. If you’re like most of us, meaning that you eat a significant number of meals or snacks outside of your home on a weekly basis, it’s virtually impossible to avoid these stripped carbohydrates and the ultra processed fats that usually come with them. They are everywhere: in every vending machine, every coffee shop, every chain restaurant. 

What about soybean, corn, or cottonseed oil? Non-dairy creamers, Crisco, or margarine? These oils are rampant in America’s ultraprocessed products. All the edible varieties of these industrial fats were invented within the past one hundred years, all are pro-inflammatory, and all have been implicated in the current epidemic of autoimmune disease. Because they are so much cheaper than nutritious fats and oils, they too are virtually impossible to avoid when you eat out. On the first Thursday in December, my 2 and 3 year old grandbabies had an unexpected snow day and I looked after them through lunchtime. They enjoyed pancakes made from 100% whole oat flour, salmon patties (made by their grandfather the previous night from leftover salmon, hemp seed hearts, and mayo), strawberries, and milk. I put out little cups of real maple syrup, raspberry jam, and peanut butter for dipping their pancakes. They ate happily and heartily.

The goal is not simply to FEED yourself; the purpose of food is to NOURISH you. Eat color. Plenty of fruits and vegetables, and beans of all shapes, colors and sizes. This morning I chopped 1 onion, 2 stalks of celery, 2 carrots (peeled), and 1 parsnip (peeled) into a soup pot containing a tablespoon of olive oil. Once they were browning I added a quart of vegetable stock and 2 cups of water, plus 1/2 cup of quinoa and 2/3 cup of red lentils. Then I added 2 tsp. salt, 1 tsp. black pepper, 1 tsp. turmeric, 1 tsp. garlic powder, and 1 tsp. cumin. I covered it, left it to cook on low heat for 1 hour, turned it off, and left it on the stove to blend all the flavors. Later today I’ll heat it up again and serve it with dinner. 

Don’t allow foods made from stripped grains (white flour, corn starch) to constitute more than a small proportion of your meals. These things don’t nourish us, they entertain us. Fun is fine, but it isn’t food. Nourishing yourself is a very kind thing to do. Food is energy, which you convert into many important things, including thinking, dreaming, and moving. 

The human body was designed to move; a body that doesn’t move pays a very high price in the long run. I will pay any price to keep myself mobile.

Please remember that you are not training for the Olympics. Be gentle. I don’t want you to overdo it. It would be terrible to injure yourself, and then spend three months healing on the couch. So go for a short walk a few times a week if you can manage that. Stretch your neck in the shower, or a couple times a day while your eyes take a break from the computer screen. Play airplane or rocket ship with your babies while they are still small, because you can be sure they won’t be that size for long. Ride bikes, or do a little yoga. Brush your teeth on one foot. Movement is a powerful mood stabilizer, and there’s nothing quite like the satisfying fatigue of a gently tired body to aid a good night’s sleep.

Do you awaken every morning feeling refreshed and relaxed? Do you fall back to sleep easily if you wake up in the middle of the night? Some people like more, and some like less, but when it comes to the inevitable stresses that come every day, are you riding the waves, or are they beating you up? Every brain needs down time, a few minutes of peace and quiet. No brain thrives if it spends every single minute on the hamster wheel, spinning around and around without rest. Take a deep, slow breath. Then take another one. 

These are some of the kinder things you can do for yourself. Nourish yourself. Breathe in and out, eat more colors, take a spin. Your body will thank you.


Your Health is in Your Heart

Good morning, and happy Sunday. Today I am sharing a conversation I had with a patient once some years ago. She was someone I had never met before, and was, like many before her, completely flummoxed about what to try next. With a personal goal of weight loss, she had already done everything she could think of, and then some. I know you know this story. I myself have told it many times before. There is a good chance you may even have experienced it yourself. Maybe you have experimented with practically every diet, including the dreaded cabbage soup diet, 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 is sustainable. You can’t eat cabbage soup for breakfast forever. So what comes next?  Continue reading


Old-Fashioned Gratitude

Many years ago, when I was eleven years old, my parents bought a Corning Cooktop stove, a fancy new appliance whose coils remained white even when they were hot. You simply had to take it on faith — or not. No matter how long I stared at that new stovetop, I could not convince myself that the white coils were hot. And that is why I still remember so clearly, this many years later, the perfectly oval burn on the tip of my right index finger. I touched it only once, but that was enough. It was all it took. I couldn’t take anyone else’s word for it.  Continue reading


YOUR HEALTHY PLATE: Bob’s Red Mill Quinoa Salad

You may or may not have heard, but last month, on February 10th, Bob Moore, a founder of Bob’s Red Mill Natural Foods, passed away at the age of 94. And I felt the need to write a post about this man who made such a remarkable difference in our food supply. Continue reading


Walking With Wellness

Some time ago, I received my first pedometer with which to track my daily steps, and I could not have been more thrilled. Attached unobtrusively to an elastic wrist band, it ventured forth with me every day as I plotted my path, set my course, stepped up, or took a hike. Continue reading


The Effects of Lifestyle on Function

Recently I wrote about a patient I met many years ago. Like most people, he spent a fair amount of time thinking about medical expenses. That was understandable, as his elevated blood pressure required treatment with four medications.

I explained to him that if he could make a couple of lifestyle changes, there was a good chance that he would be able to reduce the number of blood pressure medications he took. Could he take a short walk when possible? Could he cut back on ultraprocessed food items, like Ritz crackers and cheese whiz, and substitute homemade popcorn and a slice of Jarlsberg or cheddar on wasa crackers? What about more fresh fruit and vegetables? Maybe, but he was worried about the cost. Continue reading


With Years Come Wisdom, Guest Post by Joe Gardewin

Our recent guest post on aging inspired yet another guest post, this one by long-term reader Joe Gardewin. I hope his words inspire you as much as they inspired me!

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Dear Doc Roxanne, 

I may not be an expert on aging but, at 78, I do consider myself aged or, as my friend, Tom Isern, says, “seasoned.” In other words, most of my life is in my rearview mirror. Ha! That is not a bad thing, because I’ve had a pretty full life. But I do hope to live for a while yet and, in all honesty, I think I will. I think that, in part, because I have a good family doc who has now followed me for 20 years. In her words I am “… not the patient I worry about most.” 

These are my thoughts on [hopefully] living a long, healthy life:  Continue reading


Can You Slow Your Rate of Aging? by Guest Writer Gary Miceli

Dear readers:

Recently I received an email from Gary Miceli, a health writer with a story of his own to tell. I hope that he will return in the future to share that story, as I believe you will find it inspiring. I am happy to share with you today his thoughts on aging. Have a good weekend, and I’ll see you Sunday!  –Dr. Roxanne Sukol

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If you have read a science magazine, been to a health website or even checked out articles in the popular press, you know that human aging is a hot topic. So what is aging? Aging is the consequence of inevitable molecular and cellular changes to the structure and composition of the body. These are consequences of normal metabolism and operation.  Continue reading


Standing Together As A Family

Years ago, while caring for adults in a suburban internal medicine practice, I began to observe an interesting phenomenon. At the time, it was not unusual for my patients to bring along their children or grandchildren, fresh from a prior pediatric appointment just across the hall. Beautiful, bright-faced, chubby, usually well-behaved children. Their pediatricians’ well-intended recommendations on reducing rates of weight gain consisted of the standard, usually unsuccessful, content. My patients’ expressions told me that the advice was tiresome and frustrating. If they knew how to fix this problem, they told me, they already would have.  Continue reading