You may have some stubborn habits that are hard to give up. First, we are going to crush several dieting myths and break old bad habits. You will change how you eat. As hard as it may seem to give up treasured ideas and routines, you do want different results, so you will need to do things differently. You want to sweep out the concepts that can hold you back. All of us have been struggling with misinformation for so long that we hardly know what to eat. And perversely, it is precisely the people who have been trying to eat healthfully who are often the most confused about what to eat. We have all felt like we have been slung from one direction to another when it comes to nutrition advice. But fear not. We will enthusiastically embrace the true and enduring path to better health and well-being. And the good news is that a lot of delicious, decadent foods will actually be going back onto your “To Eat” list.
We are not going to focus on weight loss per se. Instead, we will emphasize relearning how to eat. You will eat for pleasure. Instead of limiting what you eat, you will make positive choices about what to include. Deprivation just leads to cravings and causes you to feel bad about how you are eating and the choices you make. Instead, we will focus on what to embrace, not what to exclude. So much more positive. You will choose foods that make you feel good, foods you can enjoy. A plan flexible enough to have room for your favorites, without making you feel like you are “cheating.” That is gone! Banish the very idea of “cheats.” That is not part of any emotionally healthy plan. And your emotions are just as important as physical health in this plan.
There are health and nutrition myths that get you off track and prevent you from actually becoming healthier. Many of them even have been and continue to be promoted by health professionals and mainstream media. Some come by word of mouth. But clearly, if we want different results, we need to reexamine our underlying beliefs about the things that will make us healthier, including how we eat. Let’s dispose of the myths.
“I know my body, I know what I need.” (Or “I know my body, and I’ll know if I have to go to the doctor.”) Really? You can’t sense if you have high cholesterol, high blood sugar, or high blood pressure. These are mostly silent diseases, and potentially silent killers. You can’t sense if your bones are strong enough. This is another silent killer, since the immobility from hip fractures can lead to death within one year for about 30 percent of people. There are more. I had a very dear friend who put off dealing with symptoms for a year, even though her friends strongly urged her to see her doctor. Unfortunately, by the time she saw a doctor, they found stage IV cancer. Don’t get fooled into thinking that you know your body and that everything is okay. While the Med-DASH program is super health-promoting, it’s not enough on its own to ensure good health. You are going to find key tips for optimal health here, but you still need to get regular checkups, because you can’t know which silent killers are trying to destroy your health and your quality of life.
“I know what I have to eat, I just choose not to do it.” If your eating plan or diet is too hard to follow or doesn’t fit into your lifestyle, perhaps it is off track. And if it doesn’t include the foods you really love, how can you stay with it? Perhaps you don’t know as much as you think about what to eat, and have thought that you have to be very restrictive. If you are looking to improve on what you are doing to get better results, you really need to be open to change and new ideas on diet.
“I watch my calories, but I’m not able to lose weight.” When you follow the guidelines for the Med-DASH program, you don’t need to watch calories. You will be pleasantly satisfied without overdoing calories.
“I do boot camp [or run 5 miles, do 200 crunches, etc.] every day, but I can’t lose weight.” Sometimes, when people start exercising heavily, they either increase their eating or are so fatigued after exercising that they become less active later in the day. In fact, I have seen this when counseling Olympic-caliber figure skaters. After hours of practice, some adopted slug behavior and then found weight creeping on, even while they restricted what they ate. And not all exercise will give you the results you are seeking. Doing 200 crunches or lunges will not provide much benefit for the amount of tedious effort you’re expending, and can make you hate to exercise rather than promoting a healthy, active lifestyle.
“My friend ran marathons but had a fatal heart attack at fifty. So why bother?” You may know someone who has taken perfect care of himself, but ended up having a heart attack much too young. Conversely, some people take poor care of themselves and live long, healthy lives. But we don’t know which category we fall in, until it’s too late. Most of us will get a huge benefit from having healthier habits. Our goal is to be as healthy as possible, for as long as we live.
We don’t just have misconceptions about how to be healthy, but also about what to eat. So let’s throw out what we don’t need from the counterproductive nutrition advice of the past. We will rid ourselves of the dangerous nutrition myths of the last twenty-five years!
It’s hard to imagine food guidelines recommending that someone should eat eleven or twelve slices of bread every day. But that’s exactly what we got with the Food Guide Pyramid from 1992. People joyfully piled on the carbs. Not beneficial whole grains, but plates heaping with pasta, endless bread baskets, and boxes of fat-free cookies. While Americans became more obese. Research has shown that foods that contain more moisture are more satisfying and filling. Bread? Very dry. Dense with calories. It’s so easy to finish each refill of that endless bread basket, because we don’t get full. Do you remember people eating whole boxes of cookies because they were fat-free? And yet they had the same amount of calories as the regular cookies and were higher in junk carbs.
Whole grains can be a very healthy part of the diet. But refined grains, without the fiber and stripped of most of the minerals, can become a problem, and are mostly empty calories. Your body quickly breaks down the fiber-less starch into glucose (which is our blood sugar), which then surges into your bloodstream. This may temporarily satisfy your hunger, but you will probably be hungry again in 45 to 60 minutes, when you get a sugar crash. Choosing mostly whole-grain foods instead of refined grains is more satisfying.
The proponents of juicing will tell you that your blender is a great way to help you incorporate lots of fruits and veggies, far more than you could normally eat, into your diet. Sounds great, but it doesn’t work out so well for health, and it also misses the point: Whole fruits and veggies are beneficial precisely because they are filling. They naturally help you avoid overeating. That is a good thing. (More on this topic in chapter 6.) Fruits and veggies are a great source of antioxidants. Whipping air into them, unfortunately, neutralizes much of their antioxidant potential, wiping out the benefit. Fiber also takes a hit. Those whirring blades pulverize the fiber, making it virtually useless and thus crushing one of the key nutritional benefits of plant foods. In addition, if you have fruit in your smoothie, pulverizing it breaks down the cell walls along with the fiber, which will lead to a sugar rush, followed by a crash. Intact, whole fruit gets digested and absorbed more slowly, without triggering the sugar roller coaster.
Protein or energy bars are great for athletes who need a concentrated, portable form of energy. If that’s not you, eating protein bars can be counterproductive. They are a concentrated form of energy, and energy means calories. Sugar is the glue that holds most of them together. You will find that a Snickers bar has about the same nutrient composition as most energy bars. I personally would rather have the Snickers, and I wouldn’t be fooling myself about its nutritional benefit. While protein is great to help satisfy hunger, you also want foods that contain lots of moisture to help quench hunger better and longer. Having a glass of milk with some berries or a peanut butter and jelly sandwich are both great, nutritionally balanced ways to replenish after exercise, or as an in-between-meal snack.
We’ve all heard that making small changes is a great way to develop new habits. However, if it takes a long time for you to see results, you may lose your motivation and move on without reaching any of your goals. For most of us, big changes that produce big results are powerful motivators. You just need to make sure that the changes are practical and fit into your real life. The jump-start plan in this book (see here) will give you big results through big changes and sets the stage for long-term success. Hundreds of thousands of people have adopted this strategy and love how they have been able to change their lives.
The protein guidelines from the DRIs (Dietary Reference Intakes) are based on evidence for preventing starvation. However, for optimal health and maintaining or increasing muscle mass (which is related to your quality of life and metabolic rate), protein intake should be much higher. As a dietitian, early in my career, I was trained to calculate nutrient goals for weight loss by cutting all sources of calories proportionately. It turns out that this is a very bad idea. One of the keys to sustainable weight loss is to maintain protein intake at a level that minimizes muscle loss during weight loss. You know how everyone says it is so hard to maintain weight loss? With inadequate protein, a weight-loss plan will cause you to lose muscle mass, which slows your metabolism, and makes it very hard to keep the weight off. Is that your goal? Losing weight can be hard enough without self-defeating your progress by losing muscle and slowing your metabolism.
Weight loss is not your goal. Sustainable weight loss is your goal (that is, if you need to lose weight). You only want to lose fat, not muscle. In the paragraph above, you learned about maintaining metabolic rate by maintaining muscle. You need to eat enough protein. To lose fat, we don’t want to excessively restrict fat, however, because fats are critical for satisfying hunger. It’s the empty carbs, the ones with no fiber and not much in the way of vitamins or minerals, that are the problem. Empty carbs aren’t just sugar, but also include refined grain products, which are mostly starch. Occasionally they may still be referred to as complex carbohydrates (another holdover from the ’90s). However, they aren’t that complex for the body to break down. And they get broken down into 100 percent glucose. Gram for gram, starch produces more glucose than table sugar (sucrose). Sucrose only breaks down to 50 percent glucose (with the rest being fructose). Over time, excessive intake of starches can wear out your body’s ability to produce sufficient insulin, which can lead to type 2 diabetes. Furthermore, any excess glucose your body doesn’t need for quick energy gets stored in your fat cells, primarily in your belly fat. Excess weight around your middle isn’t just a problem for how your clothes fit—it is associated with increased risk for heart disease, diabetes, high blood pressure, and some types of cancer.
While family history of heart disease is a risk factor for your own personal heart health, there are things you can do to reduce your risk. Both the Mediterranean and DASH diets are proven to reduce your chances of developing heart disease. The same goes for genetic risks for type 2 diabetes and for being overweight. While your genetic code might place you at increased odds of struggling with these issues, we are going to minimize your risk. The healthy eating patterns of the Med-DASH plan will help you seize control of your future and not be destined to relive your family history.
Who would have expected that weight loss would fall victim to political correctness and the “health at any size” movement? Certainly we do not want to promote fad diets that make us less physically healthy and the fat shaming that makes us less psychologically healthy. Yes, it is possible for people to be healthy and overweight. However, some things are not possible to wish away just to be “politically correct” about weight. Excess weight is associated with joint problems (osteoarthritis), sleep apnea, many types of cancer, gallbladder problems, decreased mobility, and fatty liver disease. And as you now know, excess fat around the middle (which can develop in people who are at a desirable BMI as well as those who are classified as overweight or obese) is associated with cardiovascular disease, type 2 diabetes, cancer, and more.1
The weight loss associated with the Med-DASH plan attacks the inflammation that accompanies excess mid-body fat. Empty carbs, such as those from foods high in added sugars and refined grains, feed the bad bacteria that can make your weight and health problems even worse, leaving you caught in an endless escalation of health problems and increasing weight. Having a diet that is packed with nutrient-rich plant foods, has sufficient protein, and is low in saturated and trans fats, while including heart-healthy fats to help make your meals satisfying, will make it easier to lose weight, thereby lowering inflammation and health risks.
While research has shown that people who journal what they eat are more successful at reaching their health and weight goals, with this program, you do not need to track calories. Rather, you will track how many servings you eat from different food groups. Eating enough fruits, veggies, protein, dairy, etc., is key to getting all the benefits of the Med-DASH eating plan, especially since DASH is based on specific ranges of servings from the various food groups. The hidden benefit of this plan is that you will feel more satisfied with your meals and snacks, without fearing that you are going to overeat. You will develop habits that will take over and make it easy to follow the Med-DASH plan without thinking too much about it. So relax and enjoy the fabulous foods!
Unfortunately, life isn’t fair. It takes so little time to consume lots of calories and so much longer to burn those calories off. For example, a typical Thanksgiving dinner of 5,000 calories is easy to consume, but would take forever to burn off. For someone weighing 154 pounds (70 kg), walking 4 miles per hour for 2½ hours would only burn 900 calories, even though you have walked 10 miles. You can see that this is completely unfair and unbalanced. It’s so easy to overdo calories, while it takes so long to burn them off. Furthermore, some people work out so strenuously that they become really fatigued and are more inactive later in the day. They go home or to the office after exercising and just sit. They may actually end up burning fewer calories during the day than before they started exercising. Or their appetite may increase, especially if they don’t eat the right post-exercise foods to satisfy their hunger and replenish their nutritional needs. This is another example of life’s unfair determination to make it hard to reach your goals for health and weight, but it is one that can be overcome by the Med-DASH program.
It’s not just “calories in, calories out.” Yes, that’s what we’ve been told. Even by prominent diet doctors and researchers. But it is not true. There is so much more to the story. It’s the way food is digested, the way it is absorbed in the intestines, the metabolic consequences of your genetics and body type, the microbiota in your gut, and your muscle mass. It is a factor of the metabolic process of storing and burning fuel in your body. Perhaps you’ve always blamed yourself for not being able to reach a comfortable weight. It’s time to stop. A fresh viewpoint will help you understand how to end your war with weight and make peace with your body.
This is my favorite one. It was so popular in the ’90s. My own dietetic association adopted this as their slogan. And it is still bouncing around. The catch is that we all became fatter trying to fit it all in. How does this provide any direction for how we should eat? I love Snickers and chips. Should I make them the basis of my eating plan? Probably not. Instead of focusing on why we don’t need to exclude certain food groups, perhaps the advice would have been more helpful if it had focused on what we should include or emphasize—so much more of an enlightening and positive message.
Lots of people think that if a food is healthy, they can eat as much as they want. For example, my husband will find a pint of blueberries in the refrigerator and finish it in one sitting. Or some people have several bowls of a whole-grain cereal because it’s healthy. Yes, of course these foods are healthy, but you really want to have a mix of healthy foods. What could you include with the berries to avoid overdoing? Something with some protein, like yogurt. What would help you avoid bingeing on cereal? Perhaps topping it with some of those blueberries or some other favorite fruit. Fill the bowl with lots of milk, which is protein rich. The meal or snack will be more satisfying (and healthy) if it contains a variety of types of foods.
Just more of the same useless advice. Eat less of what? Everything? Vegetables? Fruits? Dairy? Nope. You want more of these bulky, filling, health-promoting foods. You want enough protein, you want satisfying heart-healthy fats, and you want less of the empty carbs. It’s more important to know what to choose and what will satisfy hunger. As for exercise, there is almost no way to move enough to burn off excess calories. Yes, in general, we all do need to move more. However, certain kinds of exercise are more fun and more beneficial than others, so why not focus on the types with more of a payoff for boosting metabolism (which would not be crunches), making you stronger (which also would not be crunches), and making your life more active in general? Go dancing, walk in the park, go for a swim. But don’t exercise to lose weight—exercise because it makes you feel better and more energetic, and actually makes your body younger.
Since we are so used to having short, pithy, albeit useless nutrition sayings, perhaps we can work with some that are actually true and helpful. Ones that can help you learn how to eat in a positive way for the rest of your life. Let’s adopt some new nutrition slogans—helpful ones.
Oops! This one is really hard for many people. It can be very difficult to give up all these myths that you were told would make you healthier. For some people, it’s the smoothies or the protein bars that will be difficult to change. For others, it’s adding foods with heart-healthy fats instead of always choosing fat-free foods. They may believe it will be impossible to survive without their old ideas, which have become the bedrock foundation of how they eat. If you are here to get different results and adopt a new way of eating, let’s give it a try and move forward.
We are going to learn about a new way of eating that will make it so easy to stay on track. You will love this new style of eating and will be amazed at how far off track all your old ideas were. I love it when readers complain that they have trouble eating all the foods included in a typical day on the Med-DASH plan. That happens when you have lots of veggies and fruits, eat enough protein, and avoid reduced-fat foods. People get full. When was the last time you heard this about a diet plan? Never?
Traditionally, diet books have focused on what to avoid. Bad foods. Excess calories. Scrap that! How much more fun will it be to focus on what you want to include, not what you want to limit? What could be better than fresh foods? Delicious, beautiful food, with a Mediterranean overlay. Italy, Greece, Spain, southern France, Morocco, and the coastal regions of the eastern Mediterranean Sea. This is where the Slow Food movement isn’t just a trend but a way of life. How fabulous to be able to enjoy the flavors of fresh foods and the region’s herbs and spices! All your favorites. This is living!
It is great to find a healthy eating plan. But what good does that do you if you can’t sustain it for the long run, if you are hungry a half hour after you’ve eaten, if you or your family don’t really like the foods on the plan, or if it doesn’t fit into your lifestyle? The Med-DASH plan is going to change all that, right here, right now! Great-tasting, beautiful food. Satisfying meal plans.
Taking care of your health can seem quite a challenge in a busy life. And it might seem like it would be okay to wait a few years until you really get concerned about it.
You might be thinking about this because your doctor issued a warning about what would happen if you didn’t change your lifestyle. Or perhaps one of your relatives had an “event” such as a heart attack or stroke. You might see older people in your family who are physically incapacitated at too young of an age. You might just want to stay healthy for your kids and get them off on the right start with great habits. You might just want to feel great and be healthy for as long as you can.
There are all kinds of motivations for getting started on a new plan. But first, you need to think about what you are willing to do. If you set your expectations super high, you may disappoint yourself if you can’t be perfect, quickly. If your goal is to add more cardiovascular (aerobic) activity to your day, you don’t start by trying to run a marathon. Obviously, this would set you up for failure. But can you walk for 10 minutes? Or maybe a half hour? That would be a great start.
You want to set realistic expectations, which are achievable. Focus on your actions rather than the outcomes you are expecting. Can you add more vegetables to your diet? Sure! Can you have some yogurt as a snack? Sure! Can you spend 10 minutes walking today? Sure! Can you go to the grocery store and buy more fresh and frozen vegetables and fruits? Of course! These are practical steps you can take as you get started on this plan. By focusing more on the actions that you will take, you will find that this plan becomes much easier and less stressful than if you focus solely on your desired outcome.
In this book, you will learn strategies to make the Med-DASH plan work for your whole family. This plan will set the stage for your success. You will have meal plans that you can follow precisely or use as templates for your own food preferences. Whether you are a part-time or full-time vegetarian or a dedicated carnivore, you will find support for how you like to eat. You will learn what to keep on hand to make it easy to follow the Med-DASH program—how to stock up, how to do some prep work to make your week easier—and find recipes that are delicious as well as easy to make. Like to eat out frequently? Fear not. You will be able to maintain your lifestyle with our tips.
You are on to a new adventure. Fabulous food, good health, and desirable weight. All in one plan. Your Med-DASH program.