There has been some recent research on what makes up a healthy diet as well as some fresh looks at old data.  I think these new ideas about diet warrant another look at my recommendations for a healthy diet.  Some of these suggestions are going to look very strange to you.  I’ll back each one up with links to supporting data.

Fat and cholesterol are not necessarily bad for you

We used to recommend low fat low cholesterol diets for people with high cholesterol or other risk factors for heart disease.  It turns out, however, that eating foods high in fat or cholesterol has very little effect on blood cholesterol.  There is still controversy about whether saturated fat (the kind of fat in whole milk and fatty meats) is associated with heart disease.  Some studies show an association and some do not.  This controversy is not likely to be settled any time soon.  The best advice at this point is that it’s OK to eat some saturated fats, but they should not be a big part of your diet. Some vegetable fats, such as coconut oil and palm oil are also saturated fats. These are better, but again should eaten in moderation.

Eggs and Butter

It is okay to eat an average of 1 egg per day.  Some studies show an increased risk of heart disease from eggs, but most show no relationship between eating eggs and heart disease.  Organic free range eggs are best, because they are much less likely to be contaminated by salmonella.  Butter in moderation does not increase heart disease risk.

Healthy Fats

There are some fats that are definitely good for you.  These include fats from nuts such as walnuts, almonds, cashews and pecans. Peanuts don’t count in this category because they are actually legumes, not nuts.  Eating a handful of nuts a day actually reduces your risk of heart disease by 20%. Avocados contain healthy fats and olive oil is also a healthy fat.  Most seeds contain healthy fats as well.

Sugar

There is accumulating evidence that sugar is both addictive and toxic.  Sugar stimulates dopamine pleasure centers in the brain. It appears to be almost as addictive as cocaine. It may well be the principal cause of the epidemic of obesity and diabetes that we are seeing in the U.S and around the world.  Sugar may be the exception to the dietary rule that everything is OK in moderation.  Would  you say, for example, that a little bit of cocaine is okay as long as you don’t  overdo it?  Take a look at this YouTube video by Dr. Robert Lustig, a specialist on pediatric hormone disorders and the leading expert in childhood obesity at the University of California, San Francisco, School of Medicine.  It’s a bit long, but worth watching.

Sugar that is naturally present in fruits and vegetables is not a problem, because the amounts are small. Having an occasional dessert is fine too.  The problem is that sugar is added to almost all processed foods.  Take a look at labels for ketchup, bread, spaghetti sauce, salad dressing, etc.  If any ingredient ends in “ose” that means sugar has been added. High fructose corn syrup is the most common one.  Sugar from honey and maple syrup is no better for you than plain old white sugar.   Juices are also a problem.  Having a glass of apple juice is the equivalent of eating 8 apples. Eat the fruits, don’t drink the juices!

The only way to avoid too much sugar consumption is to avoid processed foods altogether. Stay away from the center aisles in the grocery store.  Make your own salad dressings.  Homemade tomato sauce is best, but if that’s not practical, try to find a pasta sauce without added sugar. Hunts makes one.

Bread

Gluten has gotten a bad wrap lately.  It is true that there are a small number of people who are highly allergic to gluten (It’s called celiac disease).  These people cannot tolerate any foods with gluten.  There is a slightly larger number of people who are somewhat gluten intolerant.  There is nothing inherently unhealthy about gluten, however. Widespread bread intolerance may have nothing to do with gluten, but with all the other things that are added to commercial bread. These include high fructose corn syrup (sugar), preservatives and other chemicals.  Here is a picture of the ingredients label on a loaf of commercial bread that bills itself as healthy.

I borrowed this image from Real Food Forager blog.

Real bread contains nothing but flour (preferably unbleached) water, salt and yeast.  It’s really fun to make your own bread, which is what I do.  You can also buy artisan bread that has no additives.  It doesn’t keep as long, but if you put in the refrigerator, or especially the freezer, it will last a long time.  The best bread is made with naturally occurring yeasts. In this country it is usually marketed as sourdough bread.

Starchy Carbohydrates

Carbohydrates vary in how fast they are metabolized to glucose in the body.  This is called the glycemic index.  Foods with a high glycemic index are rapidly converted to glucose by the body.  This includes most starchy carbohydrates (white bread, pasta, white potatoes, white rice, etc.).  Foods with a high glycemic index cause a lot of insulin to be released in order to handle the glucose load.  This is not necessarily good for you, and is especially bad if you are diabetic or pre-diabetic.  It is a good idea to limit high glycemic index foods.  They should make up only a small percentage of your diet.  Most fresh vegetables are complex carbohydrates and have a low glycemic index. You can have as much of these as you want.

Putting It All Together

After looking at all the evidence, my recommendation is to eat a diet high in healthy fats, high quality protein (grass fed beef, organic other meats) and mostly low glycemic index carbohydrates.  Limited alcohol is okay if you like it.

There are a number of books that are helpful in designing an eating plan like this.  My favorite is “Eat Fat Get Thin” by Dr. Mark Hyman, who is the head of functional medicine at the Cleveland Clinic.  A book with better recipes is The Whole 30 Cookbook.  This one is based on the paleo diet, which eliminates gluten altogether.  As I pointed out above, I don’t think this is necessary for most people.  There are numerous other books on low glycemic index diets.  You can find them by using that search term on google.

I’ll end this post with  a bit of personal testimony.  My wife and I have been on this eating plan for nearly a year.  I lost 15 pounds without ever being hungry and she lost 20.  Her irritable bowel symptoms, from which she has suffered for years, completely disappeared.  We both have more energy and generally feel better.

Addendum:  If you have diabetes, this type of diet may help normalize your blood sugar and reduce your need for diabetes medicines.  You should consult your doctor, however, before you embark on this plan.