Open Mike: Can't Eat Enough

Hmm, two 'Open Mikes' in three days is not good. But I want to pass along another link.

The article is "Challenge to the Insurance Industry: A Solution to Significantly Reduce Health Care Costs," by Ken Beckman, July 2016. (It was featured recently on nutritionfacts.org.)

A brief review of U.S. health care costs, from the paper: "Total expenditures exceed $2.5 trillion and have grown from 5% of GDP in 1960 to about 18% of GDP today. Heart disease remains the most common and costly condition, with over 1,000,000 bypass surgeries or angioplasties annually. Nearly half of individuals 65 and over are taking prescription drugs for high cholesterol and the total direct cost of treatments for cardiovascular disease (including high-blood pressure) is approximately $200 billion. About 45% of the U.S. population was overweight in the early 1960s compared to 75% today, with the proportion of obese individuals up nearly 200% over the same time period. This has contributed to an increase in the incidence of diagnosed diabetes from less than 1% in 1960 to nearly 7% in 2010 resulting in annual direct costs of over $175 billion. In total, about 85% of health care spending is for individuals having one or more chronic conditions."

Yikes.

What are "chronic conditions"? The "diseases of affluence" are roughly:

• hypertension (high blood pressure)
• obesity
• asthma
• cardiovascular disease
• dementia
• diabetes
• cancer
• depression

All of these are at least moderately affected by diet and least four of them (hypertension, obesity, heart disease, and diabetes) are highly affected by diet—basically, eating mainly plants and avoiding meat, dairy, eggs, refined carbs, and oil. Heart disease, named as "the most common and costly condition," is not only curable, it is reversible with diet alone. But we do what we do, (most restaurants in my area feature cuisine I've dubbed "meaty cheesey greasy") and eating plants, by contrast, is culturally considered "extreme" and "radical."

Caldwell Esselstyn responded to that:

...The truth is, the nutrition that is extreme or radical is the one that results in 1.2 million coronary stents being done per year in this country; 500,000 bypass operations where your entire chest is divided in half, [and] veins are taken off your leg and put in your heart. And they may last several years and at the end of that, you will have to have another procedure. Or, maybe it’s a little bit more extreme or radical when you spend $25 billion in statin drugs, $5 billion on stents, an epidemic of obesity, an epidemic of diabetes, an epidemic of heart disease. This is the diet that's radical and extreme.

I followed a plant diet pretty strictly for 18 months, ending in June 2021, so I could write about it here. The result was, well, radical and extreme: I lost 43 pounds (down a whopping 76 pounds from my peak, which I believe occurred in about 2014) and all my health markers improved markedly: my blood pressure went down to 110/60, my cholesterol went way down, and my sleep apnea, energy, and mood all improved very noticeably. Alas, I got depressed after my brother died and I couldn't—well, didn't—keep it up.

Head case
There were two main reasons for my failure: I'm addicted to sugar, and I can't cook. But another reason is one I still find quite odd: I couldn't eat enough. There are more or less a hundred foods you can eat without restriction on a plant diet, and, strangely, the more you eat the better. You're not supposed to eat small portions. You're not supposed to skip meals. For some reason I just couldn't get my head around that. I had "dieted" so much over the years that I just seem to associate "healthy eating" with restricted eating. Smaller portions and fewer meals. That's just not what you're supposed to do on a healthy plant-based diet. You're supposed to eat all you want, as often as you want, and the more the better, because it keeps you satiated and it displaces whatever bad foods you might be tempted to eat.

Mennonite whole wheat bread. Rosemary sets it out
at noon and it was still warm when I bought it
just now. Not WFPB, but hard to resist.

A big task in healthy eating is to come up with basic go-to meals: I need 1–2 breakfasts (one is okay), 2–4 different lunches (three is fine), and about 12–16 dinner meals (the optimum seems to be about 14*). After that the game is just to get your number up. You eat 21 meals a week; the more of those that are plant-based the better. Right now I'm eating about 13 healthy meals a week, out of my 21. That's not enough; I need to get to about 18 or 19.

Oh well. The initial challenge when transitioning to healthy eating is to stop gaining weight—the first thing to do is get a good scale, weigh yourself twice a day (before bed and just after getting up), and hold the line. Most people who are overweight or obese are continually gaining weight, and Job One is to put a stop to that. It's the old "if you find yourself in a hole, stop digging." So far I've gained nothing in the past two months, so that's a step in the right direction. (If the analogy is getting back on the horse that threw you, I have a foot in the stirrup.) But I'm still eating out too much, backsliding on @#$&! sugar, putting butter on vegetables, failing to resist the siren call of Mennonite bread, etc.

More updates eventually.

Mike

*Research indicates that even people who can cook and who cook whatever they want tend to settle down to a basic rotation of about 14 or 15 meals that they enjoy a lot and can whip up without too much bother, with an experiment thrown in every now and then for the sake of adventure or novelty, and perhaps a restaurant meal every week or two for variety.

Book o' the Week

Home Fires Volume II: The Present. There is of course a Volume I: The Past.  TOP reader Bruce Haley has produced documentary work relating to conflict, humanitarian crises and environmental/industrial/land use issues for 30 years. He received the Robert Capa Gold Medal for his coverage of the ethnic civil war in Burma.

These book links are a portal to Amazon.

Today at B&H Photo

Original contents copyright 2020 by Michael C. Johnston and/or the bylined author. All Rights Reserved. Links in this post may be to our affiliates; sales through affiliate links may benefit this site. As an Amazon Associate I earn from qualifying purchases.

(To see all the comments, click on the "Comments" link below.)
Featured Comments from:

JOHN B GILLOOLY: "I consider myself an anti-extremist. I'm 51 and been active/athlete my entire life. I too am probably addicted to sugar. I have never been on a diet, but I certainly do pay attention to all of my food. I am genetically lucky in that I could probably eat uncontrolled and max out at 210 pounds (6'1")? I am currently 177 pounds and while not nearly as fit as I would want to be, I can attribute my relative leanness to two things: first, I can honestly say that I refrain in some way at every meal to reduce the low hanging fruit. I would love a Coke, but drink water or unsweetened tea. I would love pizza or the chicken parm or the burger, but will opt for the swordfish, chicken and vegetables, etc. Would LOVE the full dessert, but literally carry around my own 70–80% dark chocolate so I can get my 'sugar-fix' in a more controlled manner.

"Second, drinking alcohol really is no longer part of my life. I will probably consume 2–3 drinks per month. I've been asking 'regular' people lately how many alcoholic drinks they consume each week and am shocked to hear that most seem to fall in the 17–25 per week range which I found shocking! Aside from the negatives of alcohol, I've found that a couple of drinks often comes with bad food choices and skipped exercise. When I say 'regular' people, I mean 45–55 year old active/involved parents who are also mostly high-earning career people."

ASW (partial comment): "My extended family on both sides was full of uneducated manual laborers: farming, logging, construction, etc. People who worked hard, all day, every day. No one ever worried about their diet, which was stereotypical Midwestern meat and potatoes with a side of meat and pie for dessert. A bigger worry was having enough food for all the kids (Catholics!). Yet, if we set aside the long-term smokers and the (many) alcoholics, they all lived into their 80s and 90s. Heck, a lot of the smokers and alcoholics made it nearly that long too. When I look back at old family photos I see thin, wiry women and sunburned, muscular men with nary a bulging belly in sight.

"My generation moved up in the world: college, sedentary jobs, sedentary lifestyles, expanding waistlines, health issues. I doubt that many will make it into their 90s.

"I'm in the middle. I got the education but don't like sitting still. I'm in my early 40s but I'm the same weight I was in high school when I played sports and worked on the farm.

"My wife and I eat primarily vegetarian (meat is an infrequent treat), mostly for environmental and ethical rather than health reasons. We try to avoid processed food, and luckily my wife loves to cook (I do not). We do not count calories or worry about portion sizes. I eat a shocking amount of food. I have been (kindly) asked to leave a Chinese buffet. I have been (less kindly) asked to leave a pizza buffet. What?

"I have run every day this year (minimum two miles; maximum twenty miles). I do pushups every day which is a habit I learned from my dad. I'm over 40,000 for the year. Although I sit in front of a computer for a job, I incorporate 'work' into the rest of my day whenever possible. I mow my one-acre yard with a battery-powered push mower. In the fall I rake the leaves by hand and carry them to the compost mountain in a wheelbarrow. I pretend that elevators and escalators don't exist. If I have to drive to a store I park at the farthest corner of the lot (also saves on damage to my car). More often than not I ride my bike into town when I'm going to the public library or to grab a few groceries. It's only two miles, which doesn't even get the car warmed up but is easy aerobic exercise for me. We go for walks and hikes with our dog for fun. Yes, it takes sweat and effort to increase your output, but that's the point.

"I always encourage anyone trying to make themselves more healthy, but I think too many people overthink it. Michael Pollan offered simple advice for the input side: 'Eat food. Not too much. Mostly plants' (from The Omnivore's Dilemma [quality hardcover and paperback; Kindle edition and trade versions; Young Readers Edition. One of the most enjoyable books of any genre I've ever read, by the way. —Ed.]). Note that when he says food he means real food: meat, grains, nuts, and veggies, not processed junk.

"On the output side, make an effort to do some sort of 'work' every day. You don't have to be a runner or a competitive body builder, but almost everyone can go for a walk and do some sort of body weight exercise. If you're stuck at a computer, use a standing desk for part of the day. Go for a walk while eating your lunch. When you head down the hall for a bathroom break, do a lap up and down the stairs afterwards. If you love watching TV at night, get an exercise bike and pedal slowly while watching. Push things, pull things, lift things, carry things (including yourself). Then do it again the next day."

Daniel: "How about the list or a reference to the list of the 100 veggies/fruits we can eat without limit?"

Mike replies: I looked around for that too and was frustrated. It's a claim from the linked article.

I can take a run at it, though. "Healthy food" is relative. Olive oil is bad for you (oils are the sugar of the fat world), but it's better than vegetable oils loaded with saturated fats. Beef tenderloin is bad for you (here's the lowdown on protein) but it's a lot better than processed meats like hot dogs, baloney, sausage, and Slim Jims. Milk is bad for you but it's better than soda pop. And so forth. Improving your food will help you even if you're still eating questionable foods.

The seven healthiEST foods are: 1. greens; 2. vegetables; 3. fruits; 4. legumes (beans, chickpeas, split peas, and lentils); 5. whole grains; 6. nuts and seeds; and 7. spices. A fair amount of these real foods are necessary for human health no matter what else people eat and no matter how cockamamie and compromised their food beliefs are. These seven things are the most nutritious foods. They supply the thousands of phytochemicals your body needs to thrive.

It's very difficult to eat a diet of ONLY the healthiest foods—I've tried—but the good news is that small amounts of "bad" foods won't hurt you in the long run. So whatever you're emotionally attached to doesn't have to be banished completely and forever. You can still eat meat once in a while as long as your gut microbiome isn't adapted to make poisons out of it; you can still eat small desserts after a meal unless it triggers cravings for more sugar; you can have pizza a few times a year; and you can even have a sugared soda pop, if you must, although a handful of times a year seems like a prudent limit. (I ate ice cream five times in 2020.) Exceptions like these are repugnant to vegan true believers and purists, and also to those who eschew animal food for ethical and humanitarian reasons, but, scientifically, where health alone is concerned, it seems reasonably clear that they don't appreciably affect health outcomes. You're an omnivore and you can survive on the world's worst foods for shortish periods—it's a tribute to our extraordinary adaptability that it's even possible for humans to survive on McDonalds meals and highly processed foodlike substances from gas stations or convenience stores. You won't thrive, but still, we're amazing.

Peter Croft: "Keep writing about food and healthy eating Mike. I really enjoy your articles and opinions."

Comments

[Mike Ferron]

Right now I estimate I eat cleaner than 95% of my fellow Americans. Getting there took awhile via research and then eliminating the culprit foods that lead to a bad diet. What is hard is the foods we love the most are often the worst for you. After a time though folks will find taste buds change and what I’ll refer to as food addictions fade then disappear. When that happens something as simple as a ripe strawberry tastes amazing. (Says the guy who is down 35 pounds and finally has a BMI that finally was nudged into the normal range.)

[darlene]

I have been a vegetarian most of my life. When I prepared meat inclusive meals for my husband and son, I did taste them, but honestly, I do not like the taste or texture of meat. I am the same way with alcohol. Tried it when an older sibling gave it to me in high school, got drunk, vomited because I could not stand the taste and never forgot it. I have had mixed drinks years ago when out on dates, but when forty rolled around that all stopped because of a headache coming on before the first drink was halfway done. I never liked the taste of it and have never had a craving for it. No alcohol for me!

I have had to add supplements to my daily intake, primarily B12 and D3 because although I have never required any Rx drugs for what you outline, my blood work at times shows deficiencies in B12 and D3. How can a Florida girl that goes camping and hiking on a regular basis suffer from "lack of sunshine" (D3)? My doctor has questioned that before. It happens.

I never liked the taste of eggs, but was told by my doctor to try and incorporate them in my diet. So I tried various ways of cooking them and found if I make a pot of healthy rice once a week, add sauteed onions, fry a portion of the mix in a cast iron pan and add two eggs whisked with about a ¼ cup of water, then after it is in my bowl, add hot sauce on top. Now that does taste good to me.

Am I picky eater? Mom always said I ate like a bird, but I do get hungry! I could never eat the diet most people seem to. I grew up with a mother that was an incredible baker. Hot, fresh coffee cake with peaches or apples every morning placed in my hands as I ran out of the house to catch the school bus. Only problem is, you can develop a sugar addiction or become immune to its flavor, requiring more over time if you eat breakfast cake every day.

The only way I found that stopped my sugar cravings was, time. When I stopped eating sugary foods, I went through a withdrawal period of about two weeks, the cravings stopped. I tried it again and again to see if it is true enough to spread the word from experience, and "yes" you can stop the cravings once and for all. I can easily walk past the pastry asiles without a flinch. Seems to work if you are determined to stay off of it forever.

For me it is about developing healthy habits. Humans can get addicted to all kinds of things including their food intake. My biggest hurdle these days in not wanting to put the time into cooking fresh vegetables every day, I get tired from my other activities. Instead of butter on your veggies, try olive oil, it works for me. I keep no butter or sugary food in my home. Since I live alone now, It is much easier for me to control what is in the cupboards and freezer. I reward myself with vegetarian pizza about twice a month, especially on a weekend day I am utterly exhausted and do not want to make a smoothie or turn on the stove or instant pot. We can learn better eating habits if we want to, "if we really want to."

[I agree with you about sugar. I don't think it's technically addicting, because what's missing is physical withdrawal symptoms. And it's much easier to get off than, say, alcohol or especially cigarettes. What I've read is that the cravings go down significantly after four days and approach zero after two weeks, which accords both with what you say and with my experience. One thing that seems curious to me is that after I eat a lot of sugar or especially bread, I feel bad for hours...yet this doesn't seem to persuade me not to do it again. You'd think that this cycle would lead to some sort of aversion, or at least a conscious awareness of consequences. One way that sugar is like alcohol for me is that I don't seem to be able to eat small amounts. Eating any at all seems to lead invariably to eating lots. Even just having sushi (the rice is made with sugar) will start up cravings again. (A story I heard from an alcoholic: at a garden party where people were tasting wines, he felt himself getting angry, thinking, "why can't I have a civilized glass of wine with company every now and then?" So he decided to try it. Three weeks later, his wife found him crouched on the floor of a closet, clutching a half gallon bottle of vodka and weeping. Unfortunately that's the way it is with alcoholics, and I guess a much less intense version of that is the way I am with sugar. --Mike]

[Herman Krieger]

Lose weight and feel great?

[Chris]

I was up in the Finger Lakes area last week, and vegetables do seem to be a foreign concept. There are huge tracts of land devoted to maize and dairy. As you say, the classic American dish/cuisine is meat with cheese and fries/homefries/sweet potato fries/crinkle cut fries etc etc. I assume cheese is thought to improve everything.

[Kirk]

Just considering diet may be a misguided approach to overall health. I swim with Caldwell Esselstyn's son, Rip (Author of the "Engine Two" diet book) and have spent time with Dr. Esselstyn. The one thing their entire family has in common is an almost religious attention to rigorous exercise. Rip was an All American swimmer at UT Austin under Olympic coach, Eddie Reese. He gets up nearly every morning and hits our early USMS masters workout swimming a hard, fast 3000-3500 yards before eight o'clock in the morning. He bikes everywhere. He runs almost daily (in addition to swimming (not instead of...). After workout he and a few other elite members of our masters swim team toss medicine balls back and forth, do chin ups, etc. to maintain muscle mass. And Rip has a full time job, three kids and an active family life...so it's not about time.... It's never a single cure. It's hardly ever a single cause. Not for the Esselstyn family and not for former Olympian, Dr. Esselstyn. They thrive on exercise. Diet is not a substitute for exercise in their lives.

I've read your diet posts again and again and every time I then look for the corresponding posts on vigorous exercise (which studies are now proving to greatly enhance overall health and healthy longevity. But I never seem to find more than an account of a walk up a hill or a ball toss with the dog.

I wonder if you would consider applying the same research and rigor you seem to enjoy about diets to the subject of vigorous but sustainable daily exercise, and see how the combination of a good, sustainable diet, rich in vegetables and grains COMBINED with daily exercise might vastly leverage the whole equation of your overall mental and physical health.

As a side note, my Medicare Plan (the only silver lining to turning 65) covers gym memberships entirely. As an additional side note my son studies medical outcomes for a research company that services large medical groups and associations. They've found that people's compliance with exercise programs or consistent, healthy diets is in the single digits here in the U.S.

You needn't become a world class swimmer to get good, daily exercise. The price of entry is about $100 for a good, solid pair of running shoes and a willingness to get off the desk chair and use them. Start with a daily one hour brisk walk and then get faster.

It's clearly not an "either one of the other" equation when it comes to health. The Esselstyn family is a clear example of that. Rip just hasn't written the exercise book yet. I'm sure it's coming...

[There are other benefits to exercise too, besides physical health. I went through an extended course of antidepressants in the early 2000s, just before I started TOP, which was supervised by a psychiatrist, Dr. Holloway (no therapy, he just administered the drugs and oversaw my progress). One of the things he said to me is something I'll always remember: "All of my patients who exercise do better than any of my patients who don't."

Oh, and don't mock my hill! It's about the equivalent of climbing to the top of the Washington Monument. You and Rip might run up it instead of walking, but walking isn't easy either. --Mike]

[John Krumm]

I take issue with calling them "diseases of affluence." Poor people live shorter lives, significantly shorter lives, in this country.

https://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-us-0411

So even if the wealthy eat too much, or too poorly, they tend to live longer because of other differences (health care access, food access, lower stress, cleaner air and more). While nutrition is a factor in individual health, overall, it's a social problem with social solutions, not individual ones. That doesn't mean you should eat poorly, of course, just that if you actually want to help people, we need to change the general conditions they live in.

[Richard Parkin]

I think you will find that what is killing all these people is not so much too much fat etc but too much highly processed food, which of course does usually contain a lot of fat, sugar, salt and so on.

This at least seems to be true in Europe where people who consume at least as much fat etc as the British have lower incidences of obesity and heart disease etc.

[Albert Smith]

I'm one of those people that can learn from others making mistakes. If there's a wet paint sign on a bench, and three people have stripes on their pants and shirts, well then I don't have to sit on the bench to "challenge" the sign. It's obviously true.

When both my parents died of obesity related conditions, brought on by things they did and didn't do, and all the available data corroborates their errors in life style, well I can read the wet paint sign.

It's simple, but not easy. Eat less and exercise. There's no magic formula or quick fix. Simple, but not easy. Watching someone's last years be so hard and debilitating is a great motivation to not sit on that bench.

Maybe not for everyone, but Bill Maher did this monologue on obesity in America last week, and took a lot of crap for it. I agree with his points.

https://youtu.be/yfiWjnStE3w

[Christer Almqvist]

I like chocolate a lot. Not Mars bars and things like that. But it need not be real expensive stuff. That is often hype anyway. But high quality, like Lindt. I can finish three 100g/4oz bar in a few hours. Wonderful. And not only that; after having enjoyed all that, I do not crave any chocolate for a month.

The real solution to healthy eating is cooking your meals. Not heating processed food. Cooking makes your reflect on what you eat and if you have a partner, then cooking together is very good for partnership.

[Speed]

This will be a "half full" comment ...

USA Life Expectancy at Birth
1900: 47.3
1950: 68.2
2000: 76.8
2018: 78.7
https://www.cdc.gov/nchs/data/hus/2019/004-508.pdf

Deaths by heart diseases in the U.S.(per 100,000 population)
1950: 588.8
2018: 163.6
https://www.statista.com/statistics/184515/deaths-by-heart-diseases-in-the-us-since-1950/

Rates of the 4 leading causes of death in the United States in 2020 (per 100,000 population)
Heart Disease: 168.2
Cancer: 144.1
COVID-19: 85
Accidents: 57.6
https://www.statista.com/statistics/248622/rates-of-leading-causes-of-death-in-the-us/

Some of the lifesaving medical miracles that in our lifetimes have become routine: Chemotherapy, CABG, Diuretics, Beta Blockers, Orthopedic Implants, balloon angioplasty, stents, pacemakers.

Cost of healthcare? Headlines say it's out of control and in many cases they're right ... but not in all. Hope springs eternal but not without hard work.

[Mark Cotter]

I get where you are coming from.

Having had a wake up call to health and diabetes - I’ve yo-yo-Ed in and out of the diabetes zone in blood tests in the past 18 months - the book I’ve found most useful is by Jessie Inchauspeand entitled ‘Glucose Revolution’. The science and life-hacks contained within it have enabled me to lose just over 30lbs in six months and made me feel significantly better.

Sugar is the cause of most, if not all, of our health problems and this book helps one get it in check. I highly recommend it.

[PaulW]

"...avoiding meat, dairy, eggs, refined carbs, and oil". Many doctors, scientists, weight loss experts, etc would disagree with lumping refined carbs in with the other foods on this list, all of which can be part of a healthy diet that will enable one to lose weight. Have a read of Gary Taubes "Why we get Fat", or anything by Dr. Jason Fung.

[I really believe the science says you're wrong, but we can disagree. --Mike]

[Gregory Kriss]

About 15 years ago I suddenly discovered that I had inherited high blood pressure and high cholesterol numbers. Bought a copy of Robert Haas's EAT TO WIN (the sports nutritional bible) and started to bike 25 miles per day. I had to give up biking daily, but still adhere to the advice from Robert Hass's book. Weight has been stable and other health issues under control (albeit most probably from daily meds and supplements). The book EAT TO WIN is not at all like a diet book but more like a way of eating healthy.

[Peter Nigos]

An innocent question. Why do photographic blog writers feel obliged to promote advice on nutrition and health care ?
In addition to TOP, Lloyd Chambers frequently likes to give medical opinions to his readers. Samantha Peel ("Wellyphoto") unabashedly combines photography and recipe advice. Even Ansel Adams once published a list of food for exploring the backcountry, and wrote out a recipe for poaching eggs in beer. I thought Ken Rockwell might be prepared to offer me some medical help, but so far he has resisted.
Next I expect a top chef to list his favourite lenses for micro-2/3 systems.

[Because we care about aesthetics? I don't know. I didn't know other photo bloggers do it. --Mike]

[Keith B.]

"--basically, eating mainly plants and avoiding meat, dairy, eggs, refined carbs, and oil."
It's the refined carbs mostly.

[Luke]

"basic rotation of about 14 or 15 meals" -- Umm, maybe 4 or 5? Or 3?

I always read your food posts, and pay some attention, too. Thank you.

[Olybacker]

Good post, Mike, and well done on the weight loss.

[Jim Kofron]

Hey Mike:

A couple comments--I've been trying to stick with WFPB, although it's a little tougher as I transition to getting back to the office. More prepackaged temptations here. But I'm still pretty good with this--I'm making sourdough bread weekly (and I grind my own flour as well), cooking and eating lots of WFPB meals. When I travel, I cut myself a break. In fact, a couple months ago I was up in your neck of the woods--went out with my sister and brother-in-law to Galene (north end of Conesus lake). I had a nice vegetarian dinner--but for dessert I conned the table to help split an order of lamb chops that they had as one of the entrees... Delicious!

The second comment addresses the 'why do photographic blog writers...'. I always think of you as a writer first: your interests are not just photography but pool, nutrition, culture, cars, music, relationships... and the list goes on.

A third comment (I lied about two) to Daniel. You can pretty much eat any fruit or veggie you like without limit. If you're sticking to the WFPB mantra, you'll do fine with that and there's no need for counting calories. So it's the top 100 of those that you like. Add nuts and seeds too. And some legumes or other protein sources.

[JOHN B GILLOOLY]

I think the half-empty version of Speed's comment is that it is medicines that are keeping people alive longer. People with all of those chronic diseases that could mostly be managed by a healthier lifestyle are not really even asked to consider changing their lifestyle. They are just given more and more medications.

I guess what we are also talking about is quality of life, which is subjective. There are millions of people that are "living their best life" on a cruise eating and drinking to happy excess daily. They will happily take the meds as a trade.

I personally have a different calculus on "living my best life" and am not willing to make that trade.

To each their own, but it is a shame that most people think medications are the ONLY option to all these diseases.

[ASW]

You can put as much effort as you want into a healthy diet, but exercise has to be half of the equation.

If input = output your weight will stay constant. If you unbalance the equation in either direction you can predict what happens to weight and eventually health outcomes. We have several overlapping problems in the US. Too much input, low quality/processed inputs, and too little output. That equation isn't working out for us.

My extended family on both sides was full of uneducated manual laborers: farming, logging, construction, etc. People who worked hard, all day, every day. No one ever worried about their diet, which was stereotypical Midwestern meat and potatoes with a side of meat and pie for dessert. A bigger worry was having enough food for all the kids (Catholics!). Yet, if we set aside the long-term smokers and the (many) alcoholics, they all lived into their 80s and 90s. Heck, a lot of the smokers and alcoholics made it nearly that long too. When I look back at old family photos I see thin, wiry women and sunburned, muscular men with nary a bulging belly in sight.

My generation moved up in the world: college, sedentary jobs, sedentary lifestyles, expanding waistlines, health issues. I doubt that many will make it into their 90s.

I'm in the middle. I got the education but don't like sitting still. I'm in my early 40s but I'm the same weight I was in high school when I played sports and worked on the farm.

My wife and I eat primarily vegetarian (meat is an infrequent treat), mostly for environmental and ethical rather than health reasons. We try to avoid processed food, and luckily my wife loves to cook (I do not). We do not count calories or worry about portion sizes. I eat a shocking amount of food. I have been (kindly) asked to leave a Chinese buffet. I have been (less kindly) asked to leave a pizza buffet. What?

I have run every day this year (min 2 miles; max 20 miles). I do pushups every day which is a habit I learned from my dad. I'm over 40,000 for the year. Although I sit in front of a computer for a job, I incorporate "work" into the rest of my day whenever possible. I mow my one acre yard with a battery-powered pushmower. In the fall I rake the leaves by hand and carry them to the compost mountain in a wheel barrow. I pretend that elevators and escalators don't exist. If I have to drive to a store I park at the farthest corner of the lot (also saves on damage to my car). More often than not I ride my bike into town when I'm going to the public library or to grab a few groceries. It's only two miles, which doesn't even get the car warmed up but is easy aerobic exercise for me. We go for walks and hikes with our dog for fun. Yes, it takes sweat and effort to increase your output, but that's the point.

I always encourage anyone trying to make themselves more healthy, but I think too many people over think it. Michael Pollan offered simple advice for the input side: "Eat food. Not too much. Mostly plants" (from 'The Omnivore's Dilemma'). Note that when he says food he means real food meat, grains, nuts, and veggies, not processed junk.

On the output side, make an effort to do some sort of "work" every day. You don't have to be a runner or a competitive body builder, but almost everyone can go for a walk and do some sort of body weight exercise. If you're stuck at a computer, use a standing desk for part of the day. Go for a walk while eating your lunch. When you head down the hall for a bathroom break, do a lap up and down the stairs afterwards. If you love watching TV at night, get an exercise bike and pedal slowly while watching. Push things, pull things, lift things, carry things (including yourself). Then do it again the next day.

[robert e]

Maybe the recommended book this week should be one called Home Fries (as another commenter misread it the other day).

"As far as I can tell, the common thread through all of this is Michael Pollan's haiku: 'Eat food, mostly plants, not too much.' When people eat healthier diets they do better, and it doesn't have anything to do with how much carbohydrate or protein or fat they ate." (Emphasis mine.) Marion Nestle, author of Food Politics (https://www.amazon.com/Food-Politics-Influences-Nutrition-California/dp/0520254031 ), as quoted in https://www.vox.com/2015/11/24/9782098/dietary-fat-saturated-fat-good-or-bad

However, Mike and others seem to be telling us here that "not too much" actually means "a lot". I laugh in recognition. I also know from experience that trying to eat less leads to compromises, which undermines health goals. But here's one way in which the misguided blanket condemnation of fats has done so much harm, because fats are satisfying, nutritionally dense and healthy (as long as they weren't concocted in a factory), and are, and always were, a way out of this particular problem.

Unfortunately, fats are a lot less healthy than they used to be, as fat is a storage medium, not only for many vital nutrients and calories, but also for a long list of industrial toxins in our environment, including heavy metals and PCBs.

On the bright side of fatty foods, like other commenters I've found that a surprisingly small amount of plain, high quality, high-cocoa chocolate is far more satisfying than endless quantities of chocolate candy (or any candy or dessert, frankly, at least for me). More cocoa also means less sugar, bite-for-bite and pound-for-pound, so it's a compound "win".

[Ken]

From your list of seven healthiest food categories, legumes and whole grains are laden with carbs, and fruits are loaded with carbs and sugar - all of it bad for a diabetic or pre-diabetic (as I am), despite the clear health benefits of those foods. On the other hand, a protein-based diet is much better for controlling diabetes, but it's not as good for your heart or for the environment. Everything is a trade-off.

[I don't believe what you say is true. But I am not an expert. I'd refer you to Michael Greger's bookHow Not to Die, Chapter 6, "How Not to Die of Diabetes," which summarizes the published medical literature on the effects of nutrition on that disease. --Mike]

[Ben]

My advice would be not to try to do everything… that’s just so hard to maintain, especially if you’re on your own, live in the country and don’t love to cook.

So put some butter on your vegetables, and acquire a taste for 80%+ chocolate. Eat a little, regularly, and no more. Try to get unsweetened bread, too, but I imagine that’s tough where you are.

I haven’t been overweight since I left home to go to college, when I stopped drinking soda and started walking/biking most everywhere. But I’ve had my best success with time restricted eating, which for me means no dinner four nights a week. I’ve always found it easier not to eat than to moderate, and keeping sweets and meats to the weekends is a good rhythm for me.

Anyway, I wish you luck Mike, as finding a balance is always challenging and we can definitely get thrown off by major life events. Or, perhaps, inspired by them… In my own family I’ve seen grandparenthood be an ongoing positive inspiration… just to give an example.

[adamct]

A few thoughts from someone who managed to lose about 70 lbs and then settled at a fairly healthy weight. (I'm not trying to be prescriptive, just sharing my personal experience.)

1. Making decisions is hard. Making good decisions all day, every day is virtually impossible. From my experience, the primary benefit of becoming "fegan" (I call myself a fake vegan*), is that by ruling some foods off limits, I have to make fewer decisions. It is much, MUCH harder to decide NOT to have a steak, or to only have one scoop of ice cream, than it is to just rule those foods out of bounds and choose among the relatively healthy options that are left. Being "fegan" is a decision-making crutch for me.

2. Similarly, while moderating your intake of sugar, processed foods, and meat/cheese and allowing yourself a small amount may sound less extreme than forgoing them entirely, that hasn't been my experience. Once I eat a little bit, I want more. On top of which, I then find myself hungrier. When I eat less, and only eat whole foods and plants, I am actually LESS hungry. It seems weird, but it's true. Try it for a few weeks. What have you got to lose? It's not an irreversible experiment.

3. Lastly, get all the junk out of your house. Again, for me, it is all about reducing the need to make decisions. If I do get hungry, and there are chips or crackers in the house, it is very hard to keep deciding not to eat them. But if there aren't any chips or crackers, but there are nuts, then it is very easy to eat the nuts.

Just one man's experience.

Best,
Adam

* I doubt anyone cares, but if you want to know why "fake vegan", it's because I am fully vegan at home, but I do eat seafood when eating out if there aren't any appealing vegetarian options, and when eating out or at friend's houses, I don't ask if vegetarian options include butter, milk, eggs, etc.

[I agree with everything you've said here. I do know that when I'm eating strictly WFPB I'm definitely less hungry, and that even small amounts of sugar trigger cravings for more. And, my house has literally no junk in it. My fridge is almost empty in fact. Finally, I also have decided to eat what I'm served when I'm at friends' houses. I don't want to be "one of those" vegetarians. --Mike]

[Gunny]

The listed diseases are not exclusive to the affluent (one of the perils of list making).

[They're called that because they're associated with Western diets such as the SAD (standard American diet). As soon as traditional peoples eating plant-based diets switch to Western diets, incidences of those diseases shoot up. It's been documented over and over again with many populations. --Mike]

[Mark]

I find this topic interesting & have been influenced by books such as 'How Not To Die' & also 'Fiber Fuelled', which is about the microbiome. It is definitely best to make your own fresh food and fortunately I am happy with a fairly limited range of simple meals. Overnight oats for breakfast (rolled oats, soy milk, nuts and seeds, turmeric, cinnamon powder); rice, lentils, beans & greens salad for lunch most days; and lots of soups and stir fries for dinner. I also agree with those who mention exercise and at the moment I am really into power walking, e.g. 30 minutes of intervals of 1 minute purposeful walking followed by 30 seconds of fast walking.