Food


Philosophy on Nutrition

What kind of nutrition plan is optimal? The best piece of advice comes from whole food activist and best-selling author Michael Pollan: “Eat food. Not too much. Mostly plants.”

Sounds simple, right?

It actually is simple, but most of us get side-tracked by all the confusing information out there.

The best nutrition advice is to look at where all reasonable diets overlap. These areas of overlap suggest that the optimal diet includes vegetables, fruit, plant-based protein, high-quality animal protein (on occasion), monounsaturated fats, whole grains, omega-3 rich foods and fermented foods.

I encourage patients to eat a diet that is plant-forward. What does it mean to be plant-forward? I advocate for a diet that’s at least 80% plants. A plant-forward diet emphasizes foods like vegetables, fruit, whole grains, nuts, seeds, legumes, whole organic soy, and chocolate (hooray!) and has fewer foods like beef, pork, poultry, fish, dairy and eggs.

How do you do eat mostly plants? As a girl who grew up in Ohio with animal protein at almost every meal, this was definitely a shift for me. I have learned so much and have devoted a significant amount of time to sharing some delicious plant-based recipes with you under Recipes.

 
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Vegetables

Most people should eat between eight and ten servings of vegetables per day, with a serving equal to ½ cup cooked or 1 cup raw or 2 cups salad greens. When I share this with patients, many of them swallow hard and ask, “Well, Dr. Katie, if I’m eating all of those vegetables, what else am I eating?” To which I reply, “That’s the whole point – a diet that is plant-forward is mostly vegetables!”

Start with making vegetables at least half of your plate at each meal. You can do this at breakfast, too. If you’re not used to eating vegetables at breakfast, it can be strange at first…but, I promise you, you’ll get used to it.

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Now, of course, there are some idiosyncrasies based on your personal constitution. Not everyone is made to eat every food. Do cruciferous vegetables like broccoli or cauliflower give you terrible gas no matter how you prepare them? Well, maybe those aren’t the best choices for you until you figure out why that’s happening. But good news: there are a lot of other delicious vegetables out there to enjoy!

Plant-Forward Protein

Usually protein is the biggest concern in a plant-forward diet. Most Americans over-consume animal protein on a quest to follow a low-carbohydrate diet. There are many delicious sources of plant-forward protein that give us the amino acids we need to maintain our muscle mass, including whole organic soy, lentils, beans, other legumes, nuts, and seeds. Aim for 55-70 grams of protein per day if you are an average person.

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Healthy Fat

Healthy fat at each meal is the key to satiety. I try to have 30% or more of my calories each day from plant-based fats like olive oil, raw nuts, raw seeds, avocados and (my favorite!) extra dark chocolate. Since fat in our diets is more dense than carbohydrates or protein, that 30% shows up on the plate looking smaller than our proportion of vegetables, whole grains or protein. In my graph above, this equates to about 15% of volume on your dinner plate.  Most of our fat should be monounsaturated, but there is evidence to include plant-based saturated fats and medium chain triglycerides like coconut oil.

One easy way to incorporate more healthy fat into your diet is to roast your vegetables with extra virgin olive oil (EVOO). I grew up in the 1990s when low-fat was all the rage, and my mom loved to use a steamer.

These days, I roast or dress almost all of my vegetables with EVOO. This method is so much more delicious!

Extra dark chocolate is generally at least 85% cacao and is rich in saturated fat, a key component in our diet. We use saturated fat for building cell membranes and other important lipid functions. The saturated fat in dark chocolate, however, is made mostly of stearic acid. Stearic acid, unlike the saturated fatty acids found in animal proteins, is very anti-inflammatory. I eat some extra dark chocolate almost every single day and definitely have it in my bag when traveling since it’s the perfect snack.

Whole Grains

Let’s also discuss whole grains. This is a confusing topic for many people because it seems like EVERYTHING at the grocery is labeled “whole grain.”  Whole grains include grains like brown rice, quinoa, farro, amaranth, millet, and steel cut oats. These grains come from the ground and appear on our plate in pretty much the same form; they haven’t been processed into anything else. When we eat whole grains, we preserve the intrinsic fat and fiber to help make the release of sugar in our bodies slow and steady, having a more positive effect on our blood sugar than processed grains, which become sugar almost instantaneously. In your body, there’s almost no difference between eating a spoonful of sugar and a highly processed grain like pasta, crackers, chips or bread. So consider those starches like treats and make them less prominent in your diet.

A note on gluten here: gluten is not inherently evil. Unless you have an allergy to gluten (called Celiac Disease) or a strong sensitivity to gluten, you can certainly enjoy it. I would definitely recommend regular consumption of glutenous grains like barley or farro on a regular basis. However, processed foods containing gluten, like crackers or pasta, are not good for anyone because sugar is not good for anyone.

Likewise, just because a product is gluten-free does not mean it’s healthy. Pasta is unhealthy regardless of whether it’s lentil pasta, brown rice pasta or whole wheat pasta. The same is true for crackers or any other processed product. It doesn’t matter if your crackers are made from chickpeas or any other healthy food. Once a whole food is processed into something that doesn’t exist in Nature, it’s by definition unhealthy. It’s a treat in the diet and should be consumed as such. If your great-great-grandmother wouldn’t recognize it, then you shouldn’t eat it very often.

Fruit

Many of my healthy patients overdo it with fruit. Sure, fruit is healthy, but it’s also a natural sugar. What makes whole fruit perfect is that Nature combines the natural sugar with fiber, so the release of insulin in the body in response to sugar is slowed. Highly-pigmented colorful fruit like berries are some of the best fruits to eat. I mean, who can argue with something that’s Nature-made and bright red or blue? Many patients say they avoid bananas or grapes because of the sugar content, but then go on to consume sugar in other processed forms like lentil pasta. That does not make much sense! Yes, it’s better to consume bananas when they are on the green-yellow side, but trust that Nature made you some delicious dessert options and enjoy two or three servings of fruit per day. Maybe an apple a day does keep the doctor away!

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Omega 3 Rich Foods

I have a special place in my heart for wild salmon. I just love it. Omega 3 fats are not the most common types of fat in our diet, so it’s important to seek this food group out.

If you eat animal protein, I recommend getting a 3.5oz serving of wild Omega 3-rich fish per week, like salmon, black cod, halibut, herring or sardines. Tuna and mackerel are also rich in Omega 3s but can be sources of mercury if over-consumed.

While animal Omega 3 is more bioavailable (i.e. usable in the body) than plant-based Omega 3, it’s important to include plant-based Omega 3 in your diet in the form of walnuts, ground flax seeds, chia seeds, whole organic soy, and many other nuts and seeds.

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Fermented Foods

Fermented foods are high in probiotics, the natural little bacteria that live in our digestive systems and keep us healthy. In fact, each of us has around 1kg of bacteria hanging out in our systems right now!

Probiotic-rich foods include miso, kimchi, sauerkraut, tempeh, kefir, yogurt and kombucha. This girl grew up eating sauerkraut and loves sour stuff, so I don’t mind fermented foods at all; however, I recognize that this is not true for everyone. Do your best to have one probiotic-rich food per day if you can. Although I don’t love the effect of animal dairy on our bodies, I do make a special exception for fermented dairy like plain yogurt and kefir if it agrees with you. It’s important to buy plain so that you don’t drown the good little guys in sugar before consumption.

And do you know what probiotics eat in your digestive system? Prebiotics. Prebiotic-rich foods are those with high fiber content. In fact, every time you eat something that’s high in fiber your probiotics eat some of the calories you consume. Take a handful of almonds, for example, which may have 150 calories. Your little probiotics are so psyched to have that fiber that they consume approximately 30 of those calories. This is a great example of how “calories in” do not necessarily equal “calories out.”

Whole Organic Soy

Many of my patients are scared of soy thinking that it will raise risk of breast cancer or give them man-boobs, but you don’t have to be afraid. The type of soy I advocate for is whole and organic, meaning that it’s got the right ratio of isoflavones to make it anti-inflammatory in the body. (Isoflavones are the building blocks of soy. The most important ones are genistein and daidzein.) Consider consuming one serving per day of whole, organic soy like edamame, soy nuts, soy milk, tofu and tempeh. This is safe even for survivors of breast cancer, according to a recent study. I feel confident about this and serve whole organic soy to my two sons often.

Hydration

It’s important to stay well-hydrated for so many reasons. First of all, our bodies are mostly water and we depend on a well-hydrated system for optimal function. Secondly, your body can often misconstrue hunger for thirst, making you think you’re hungry when in fact you’re just thirsty.

Everyone’s water needs are different, but most people need two or more liters per day. A good judge of your hydration status is the color of your urine, which should barely turn the bowl yellow…the color of champagne, people say. If it’s darker than that, then you should consider more water. I advocate for drinking most of your daily water before the late afternoon so that you don’t cause unnecessary awakenings at night due to urination.

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Caffeine

Don’t feel guilty about a little caffeine. Research shows there may benefits to modest caffeine in the diet, especially when it comes to cognitive decline. Each cup of coffee or shot of espresso ranges from 60-100mg of caffeine, depending on how it’s brewed. Green tea has a fraction of that, with somewhere around 15-30mg per cup. I recommend keeping caffeine to one or two cups of coffee or less than 200mg per day.

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Tea

I love the ritual of a cup of tea. It causes me to slow down my mind and savor the moment.

There’s a special place in my morning routine for green tea. Green tea might be the most anti-inflammatory food on the planet, and it doesn’t matter if it’s decaf or regular. I love hot beverages at breakfast, but green tea can also be a nice pick-me-up in the early afternoon with a square of extra dark chocolate. The tea warms your palate just enough that the chocolate will pleasantly melt.

Watch for teas with added ingredients like citric acid, “natural flavors,” sugar or stevia. It’s best to enjoy single or blended teas without additives.

Alcohol

Now here’s a subject that won’t win me friends, since I tend to think we over-consume alcohol as a society. Alcohol is delicious and contributes to feeling relaxed. And it’s positively correlated to better cardiovascular health. But, as my favorite Cardiologist says, “Ladies, it’s one drink a day and you can’t save it up!” Just because you didn’t drink Monday through Wednesday doesn’t mean you can have three drinks on Thursday! For women, I recommend one or fewer drinks per day, and for men it’s two or fewer drinks per day. Ideally, you might have a drink three or four nights per week, but only if it brings you joy. There’s no reason to start drinking alcohol if you don’t enjoy it.

Dairy

After experimenting without dairy in my own life, I can honestly say that I feel better when I don’t eat it. It pains me to say that because no one loves ice cream more than this girl. You have to admit, it’s weird that we as humans drink the breast milk of cows and goats, right?

These days there are so many great plant-based dairy alternatives that you don’t have to feel deprived. Check out coconut, cashew or almond yogurt. Consider soy milk, coconut milk, oat milk, hemp milk, macadamia milk or make your own almond milk (it’s actually pretty easy). There are even beautiful cheeses made from cashews that can be enjoyed in small amounts.

If you do eat animal dairy, use it in the way it was intended: to make the rest of your food taste better. Consider sprinkles of dairy in your diet instead of giving it prime real estate on your plate, such as a little half and half in your coffee or a tablespoon of cheese on your salad or a spoonful of whipped cream on your apple oatmeal crisp.

Sweets

Newsflash: sugar is bad for you. Obviously. But it’s so delicious!

Treat sugar like the treat that it is, and have it sparingly in your diet. Remember, a treat is no longer a treat if you have it all of the time!

Most of us are hip to the overt sources of sugar in our diets like candy and desserts. Be careful of sugar that masquerades like a healthy food. A good example of this is processed whole grain products like most breakfast cereals and whole grain bread.

It’s also good practice to start sweetening foods yourself, as food companies will almost always put more sugar into something than you would. A good example of this is sweetened yogurt, one of my pet peeves. Buy plain yogurt and sweeten it yourself.

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Many patients ask me about what types of sweeteners are most healthy. To be fair, sugar is sugar, no matter where it comes from. That said, maple syrup and honey may be superior to table sugar or agave due to their lower fructose content.

Always choose nutritive sweeteners (those with calories) over non-nutritive sweeteners (those without calories, usually in the form of artificial sweeteners). The jury is out for me on stevia, which is technically a natural non-nutritive sweetener. A landmark study came out in 2016 which suggests that our probiotic-rich microbiome is completely disrupted by non-nutritive sweeteners, which independently increase the risk of metabolic diseases like diabetes and obesity.

Avoid sweetened beverages like soda, juice, sweet tea, and sports drinks like the plague. They aren’t good for you at all. At our house, my boys treat juice like gold and know it’s an extra special day when Mommy lets them have it.

Follow the 80-20 Rule

I seem a little strict, right? Well, that’s where the 80% comes in. No one needs to be perfect. Just like in other parts of life, if you do well 80% of the time then you don’t need to feel guilty about the remaining 20%. This girl loves sweet desserts, crusty bread, savory cheeses, robust wines, salty French fries and juicy burgers, so I make allowances for indulgences like those each week.

 
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Recipes

A note on recipes: I am an avid researcher of new recipes and take inspiration from many places. One of my favorite ways to get new ideas is to borrow cookbooks from the library! My recipes are my healthy takes on others’ ideas, and I give credit when I can to the original source, whether it be a cooking magazine or a friend or my mom!

In general, my cooking hacks are to take any recipe and do the following:

  • Multiply the vegetables by 2-3x and incorporate more staple vegetables (like celery, carrots, onions, which I always keep on hand)

  • Choose leaner cuts of animal protein when possible (choosing sirloin steak instead of ribeye, for example)

  • If a very heavy dressing or sauce, decrease the fat by 1/3

  • Decrease all sugar by 1/3 - ½ (including natural sugars like maple syrup or honey)

  • Substitute plain full-fat Greek yogurt for sour cream or plain kefir for buttermilk

  • Use nutritional yeast instead of a sprinkle of cheese

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