Enough people have asked me if the kind of cholesterol in egg yolks is good or bad (hint: it’s neither) that I think it is time for a brief tutorial on this misunderstood molecule.

Rather than put you to sleep with a watered down version of a Wikipedia article I decided to explain the interaction of diet and cholesterol in a short video. Hopefully this will help clear up what cholesterol is and how you should eat to minimize your risk of heart disease.

As always, feel free to drop me questions in the comments.

If you like this story follow me on the new Digg!

http://forms.aweber.com/form/30/split_210533730.htm

Further reading:

• How To Raise Your HDL Cholesterol
• Intact Grains vs Whole Grains
• How To Make Eggs Taste As Good As Bacon
• Book Review: Good Calories, Bad Calories

Organic Vegetables

There has been a lot of back and forth trash talking between fans of organic and fans of conventional produce ever since a new review study by the Food Standards Agency (FSA) reported no nutritional superiority for organics. Let’s take a look at some of the opposing arguments and have a vote.

Since the publication of the review last week I have been collecting the opinions of various experts around the internet.

A few fabulous articles are worth noting:

• Organic Versus Conventional Food: UK Report Flawed by Paula Crossfield at Civil Eats. This is the best analysis I have found. If you only have time to read one article of criticism, make it this one.
• Organic Center Response to the FSA Study is particularly interesting because it points out that the FSA actually did find a nutritional benefit of organic foods, but simply decided the differences were not important.
• Soil Association response to the Food Standards Agency’s Organic Review presents some additional scientifically valid criticisms/omissions of the report.
• Today’s huge flap about organics. NYU professor of nutrition, Marion Nestle, offers her usual dose of common sense: doesn’t taste matter to anyone?

Key criticisms of the FSA report:

1. The nutrient analysis is questionable and incomplete.
2. Findings contradict conclusions of other scientists.
3. Report does not account for the presence of toxins and contaminants.
4. Conflicts of interest may exist among the investigators of the report and agribusiness.

So what do you think?

Do you believe the review? Think it’s a flawed piece of industry propaganda? Still undecided? How will this study affect your buying habits?

Do you even think about these things before making food purchases?

Vote in the poll and leave additional thoughts in the comments.

[poll id=”4″]

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

It was an exciting week here at Summer Tomato, including an enlightening interview with food critic Michael Bauer that led to Summer Tomato mentions in both the New York Times and the San Francisco Chronicle. Wednesday was also the anniversary of my very first blog post at my old Thought for Food blog. What a difference a year can make!

If you would like to see more of my favorite articles each week or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page. For complete reading lists join me on the social bookmarking sites StumbleUpon and Delicious. I’m very active on all these sites and would love to connect with you there.

Submissions of your own best food and health articles for future For The Love of Food posts are also welcome, just drop me an email using the contact form. I am also accepting guest posts at Summer Tomato for any healthy eating, living and exercise tips.

For The Love of Food

• To Market, To Market! Farmers Markets Should Make Some Noise During National Farmers Market Week <<Next week is national farmers market week! Celebrate by getting some summer tomatoes!! (Huffington Post)
• If we are what we eat, Americans are corn and soy <<Great piece by Dr. Sanjay Gupta over at CNN about the failing American diet.
• Organic food is no healthier, study finds <<B.S. of the week. The problem with this review is that so many of the studies cited are flawed, which I have discussed before. Big “organic” is not more nutritious. Duh. It still uses a monoculture system. However, that does not make the pesticides and chemical fertilizers any less dangerous (e.g. Parkinson’s disease, birth defects, asthma, etc.). Notably, large differences have been found in nutrient levels between biodynamically grown food and monoculture food. I recommend The Ominvore’s Dilemma if you want to understand this better. I’m sure big Ag loves this study. Please tell me in the comments if you would like me to do a thorough review of this publication next week. (Reuters)
• Use NEAT Activities to Burn More Calories <<One of the most effective ways to upgrade your healthstyle: do more non-exercise activities. (Lifehacker)
• The General Motors Diet <<Interesting op-ed in the New York Times proving that even rational, intelligent people fall into the diet trap. Don’t do it!
• The Big Question: Are You Better Than Yesterday? <<Fabulous guest post by Chad Fowler over at the Four Hour Work Week blog about how to tell if you are making progress on your health and fitness goals (or life in general).
• The Good Food Restaurant Map <<L.A. foodies pay attention! My favorite food podcast, Good Food on KCRW has a running map of the places Jonathan Gold (LA Weekly food critic) reviews each week on the show. I drool with envy every time he describes one, so if you’re in the area these are worth checking out!
• Heirloom Tomato Salad <<I love pics of tomatoes. Check out this beautiful summer tomato salad recipe. (FoodMayhem)
• Top 15 Social Media Resources for Foodies <<Great social media resources for online foodies, though it is not at all clear why Summer Tomato doesn’t appear on this list! (Mashable)
• The Claim: Refrigeration Preserves Nutrients <<I didn’t have a refrigerator for most of the week, so this article was good news for me! (New York Times)

What great articles did you read and write this week?

Jeff Miller/University of Wisconsin Madison

Last week The New York Times published a story on the life prolonging effects of a low calorie diet in primates. The study in question found that like other organisms (from yeast to worms to mice), rhesus monkeys that eat 30% fewer calories age more slowly and develop fewer diseases than animals on a traditional diet. Those of us who follow the scientific literature on nutrition and aging are not surprised by this at all.

A few days after the story was published The Times published an op-ed questioning the value of the research. Roger Cohen argues that Canto, the healthier monkey, has suffered tremendously as a result of his restricted diet. He contends that it is far better to be fat and happy (and dead?) than thin and miserable.

To me it seems questionable why Cohen believes Canto is unhappy. If he is making his judgment solely on the image above, I must respectfully disagree with his assessment. To me both monkeys appear relatively miserable.

However, Cohen brings up a crucial question about diet and health. How far are we willing to go–how much are we willing to change our diets–in order to extend our lives?

Quality of life is a very important question.

To me one of the most interesting things about calorie restriction is that life extension is only one of many health benefits. Calorie restriction literally slows down the aging process. As a result the animals subject to a limited diet are able to maintain a high level of physical activity into old age. They are also relatively free of age-related diseases including cancer, heart disease, diabetes and neurodegenerative diseases.

Extended life would arguably not be as desirable if these diseases maintained the same progression as they do in those with normal diets. But freedom from these diseases and preserved physical and mental capacities may indeed be worth some dietary alteration.

The next question is how must the diet be changed?

In the monkey experiment, the calorie-restricted group received 30% fewer calories than the control monkeys, who were allowed to eat what they wanted. It is still unknown if a 30% reduction in calories will extend human life in a similar manner, but short-term experiments have indicated that at least some benefits are immediately apparent when calories are limited, such as lower triglycerides, body fat and blood pressure.

Interestingly, however, there may be alternatives to a strict low calorie diet. Cynthia Kenyon, a scientist at UCSF, was the first to show that the key to the life extending properties of calorie restriction is the insulin signaling pathway. A decrease in insulin signaling slows the aging process and extends life.

In the laboratory, organisms like worms, mice and monkeys always receive a uniform diet that has a consistent effect on insulin signaling. But humans do not eat lab food (at least not usually).

Extensive research over the past several decades has made it clear that different foods impact insulin signaling differently in humans. For example, refined carbohydrates have a large, rapid impact on blood sugar, insulin secretion and insulin signaling. By contrast, fat, protein and fiber have next to zero impact on blood sugar and subsequent insulin signaling.

The implication of the diverse human diet is that we are able to alter insulin levels and signaling in our bodies without undergoing severe calorie restriction. Whether or not a diet that promotes less insulin signaling can slow aging in humans is still unknown, but there are many other benefits associated with a diet that lacks refined carbohydrates.

Insulin signaling is not only tied to the aging process, it is also the primary cause of metabolic syndrome–high triglycerides, insulin resistance, hyperinsulinemia, abdominal obesity, low HDL cholesterol and high blood pressure–as well as type 2 diabetes and heart disease.

A diet that improves these symptoms may or may not slow the aging process directly, but it can certainly promotes a higher quality of life by lowering the risk of many debilitating and life threatening diseases.

Going to farmers markets and eating delicious meals isn’t so bad either.

What are your thoughts on health, diet and quality of life?

Collards, Carrots and Lentils

There is much debate among nutrition scientists over whether meat eating is healthy. On one side there are the hardcore low-fat vegetarian advocates like Dr. Colin Campbell, author of The China Study, who believe all animal fat and protein is dangerous. On the other side are those who point to refined carbohydrates as the biggest threat to public health, citing studies that suggest meat alone is harmless or even helpful (for more information read Good Calories, Bad Calories, by Gary Taubes).

I tend to agree somewhat with both.

For heart disease, the evidence certainly seems to indicate that refined carbohydrates are the worst culprit. Though health advocates once pointed to saturated fat as the cause, this suggestion has not stood up to rigorous scientific testing. In fact, dietary fat (particularly from plants) seems to be protective against heart disease.

Refined carbohydrates are also the cause of type 2 diabetes and metabolic syndrome (a combination of insulin resistance, high blood pressure, heart disease and obesity), which is arguably the biggest health threat of our time.

For these reasons and many others, I avoid refined sugar and flour as much as possible in my daily life.

Heart disease and metabolic syndrome are not the only diseases that concern me, however. Cancer is another modern ailment that has been linked to diets high in both carbohydrates and meat. Though the studies are not perfectly consistent in showing harm or no harm regarding meat consumption and cancer, rarely does anything suggest meat eating is actually beneficial (though studies are almost always confounded because meat eaters also tend to eat the most sugar and refined grains).

Fish is another story entirely. Although fish is technically a meat, its properties are very different from land animals. For one thing, fish eating has consistently proven beneficial in scientific studies of heart disease and metabolic syndrome. It also seems to play a role in protecting the brain against degenerative diseases.

I am an avid fish eater and try to include seafood in my diet several times per week.

Until now, however, I have not read much about the role of fish in cancer. A new meta-analysis published in the British Journal of Cancer (part of the Nature publishing group) suggests that vegetarians have significantly less cancer than meat eaters, and that cancer rates are even lower in fish eaters.

The researchers analyzed data from two British studies of vegetarians from the early 80s and early 90s that includes over 60,000 individuals, mostly women but some men. The participants were followed until the end of 2006.

Incidence of malignant tumors was compiled for all the subjects and the relative risks were calculated. Vegetarians and fish eaters had significantly lower risk for stomach cancer, ovarian cancer, lymphatic and bone marrow cancers, and bladder cancer. Vegetarians had a higher risk of cervical cancer than meat eaters. Fish eaters had a lower risk of prostate cancer than meat eaters.

Overall vegetarians had 8% fewer cancers than meat eaters and fish eaters had 20% fewer.

Interestingly, no difference was found in breast cancer or colorectal cancer incidence, which have both been tied to meat consumption. The authors speculate that this study could be lacking in statistical power to observe a difference. However, the current data is inconsistent and no conclusions can be drawn.

While the results of this study are very compelling, there are several caveats that must be addressed. First, the number of cancers at individual sites were relatively few, meaning that findings may be exaggerated or due to chance. For me the most convincing numbers are of the overall cancer rates (the largest numbers and strongest statistics), but this leaves many questions about the causes of the different cancers.

Another issue is that vegetarians and fish eaters in the study tended to be younger and get more exercise than the meat eaters, so there may be important confounding factors that could influence the results. Likewise, studies that rely on self-reported dietary patterns have well-documented flaws (basically everyone believes they eat healthier than they really do).

It is not clear what is causing the differences in cancer incidence among vegetarians, fish eaters and meat eaters. Vegetables and fruits have been suspected of actively protecting against cancers, but so far the mechanisms are only speculative and not concrete. Recent studies have suggested vitamin D can be protective against certain cancers. Since some fish can be very high in vitamin D, this may explain some of the benefit seen in fish eaters.

The higher incidence of cervical cancer among vegetarians is also compelling and warrants further research.

Despite the flaws in this study it is mostly consistent with other research suggesting that an optimal diet is primarily fresh, unprocessed plants, some fish and little meat.

Moderation is usually the best policy.

What is your take on this study? How do you feel about health vs the ethics of fish consumption?

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

We have lots of fantastic articles this week from Lifehacker‘s food week: Eat To Live. Also featured are several healthy shopping guides including ones for fish, seasonal produce and pesticide-free foods.

If you would like to see more of my favorite articles each week or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page.

Submissions of your own best food and health articles are also welcome, just drop me an email using the contact form. I am also currently accepting guest posts for any healthy eating and exercise tips.

Note: If you have not received any Summer Tomato email updates this week please check your spam folder and mark my email address as “not spam” in your contacts. Please let me know if you have any problems with this adjustment.

For The Love of Food

• Table of Condiments Tells You When to Toss the Mayo <<I noticed this week that mustard is always expired. Here’s a nerdy guide to help you know when to toss those condiments from Lifehacker.
• 6 Reasons Why You Should Do It Yourself in the Kitchen <<I intended to include this post last week and forgot, but I couldn’t let you miss out on this simple home cooking guide from Well Done Chef! (@welldonechef)
• Loving Fish, This Time With the Fish in Mind <<Fascinating exploration of the ethical perils of shopping for fish by Mark Bittman at the New York Times.
• Health risks begin in overweight range, BMI doesn’t tell whole story <<Don’t fool yourself, any extra body weight is unhealthy says the American Heart Association.
• How To Lose 15 Pounds <<B.S. of the Week Every Friday I am tempted to wag my finger at Diets in Review for their horrible diet advice articles and product reviews like this one and this one and this one. But since my pet peeve is diet tips that will waste your time and make you less healthy, this week they get an official shout out for this uninformed article about losing weight. (No, do not follow MyPyramid. No, do not do 5 hrs of cardio unless you are training for a race. And eating less is obviously super easy, why doesn’t everyone try that? Please.)
• Make Your Brown Bag Lunch More Appealing <<I’m a huge fan of bringing your lunch to work. Lifehacker has some great tips on how to make the lunch option more appealing.
• EatingWell In Season <<Few things are better for your health than eating fresh produce that is in season. Here’s a great guide to mixing up your colors for optimal nutrition from EatingWell (thanks to Macheesmo for the link).
• Xocai and The Chocolate Weight Loss Diet – Where’s the Evidence? <<Great article by Travis Saunders over at Obesity Panacea for exposing the chocolate diet as fraud. (@travissaunders)
• Shopper’s Guide to Pesticides <<Wondering which fruits and vegetables are the most contaminated with pesticides? Let this list be your guide to organic shopping (via @reverend_bunnie from d’Arte Board)
• How To Filet A Fish Like A Pro <<Great video, again from Lifehacker‘s food week.

What great articles did you read or write this week? Leave your links in the comments.

Collards, Carrots and Lentils

A new study published yesterday in the Archives of Internal Medicine suggests that both weight loss and risk factors for heart disease can be improved following a vegan version of the low-carb, high-protein Atkins diet.

The “Eco-Atkins” diet focuses primarily on soy, nuts and wheat proteins (gluten) to increase the amount of vegetarian protein in the diet. Carbohydrates were restricted to 130 g/day, which is on the higher end of most low-carb diets. All starchy foods such as bread, baked goods, potatoes and rice were eliminated. Carbohydrates were provided in the form of whole, intact grains (barley and oats) and low-starch vegetables.

In a small (47 participants), short-term randomized controlled trial, this diet lowered bad LDL cholesterol by 20%, without negatively impacting good HDL cholesterol (statin drugs improve cholesterol levels by 30%). The diet also substantially lowered blood pressure and other markers of cardiovascular disease, such as triglycerides and apolipoprotein B.

The original meat-based Atkins diet has been shown to be effective for temporary weight loss (after 1 year the effects of the Atkins diet are diminished), but cardiovascular risk factors such as LDL cholesterol and blood pressure are not substantially improved under the traditional Atkins regimen.

Interestingly, a traditional Atkins-style diet based on animal protein was not used as a control in this study, so a true comparison of the diets cannot be made using the present data. Instead the researchers chose a control diet representative of a typical high-carb, low-fat vegetarian diet that included eggs and dairy products. Both diets tested in this study represented a 60% decrease in total calories.

Because of the study design, we cannot conclude that this diet is more effective than the Atkins diet for health, though you would predict it would be if future studies made this comparison. On the other hand, it does seem that a plant-based high-protein diet is more effective at improving health than a high-carbohydrate lacto-ovo vegetarian diet, at least in the short-term in a highly controlled environment.

This study took place over the course of 4 weeks, and all the food was provided for the particpants by the researchers. Thus, compliance in the program was very high. It is not clear if the participants would have had the same level of success if they were instructed to provide their own food to comply with the dietary programs.

Despite this, satiety levels were notably improved in the high-protein group and it would be expected that the increase in satiety would encourage greater compliance in a free living situation.

A small four week study, however, tells us very little about the effectiveness of this diet. While it is possible to improve risk factors such as cholesterol and blood pressure in such a short period of time, disease outcome is the true measure of a successful diet. Also, this study did not test the feasibility of the Eco-Atkins diet in the long-term, and it is likely many dieters would object to a strictly vegan regimen.

Interesting points raised by this preliminary study include:

• Plant-based, high-protein diets may be more effective at improving cholesterol and other cardiovascular measures than traditional lacto-ovo vegetarian diets.
• Short-term weight loss is primarily determined by the number of calories consumed, not macronutrient content.
• Low-carb diets that include intact whole grains and plant-based protein can be effective at improving both weight and cardiovascular risk factors in the short-term.
• Plant-based high-protein diets can increase satiety compared to high-carb vegetarian diets.

However, many questions must be addressed before this diet can be recommended to individuals trying to improve cardiovascular measures and lose weight.

New questions:

• Can the Eco-Atkins diet be maintained in the long-term by normal individuals?
• Does the Eco-Atkins diet continue to improve cardiovascular risk factors including weight loss after 4 weeks?
• What would result from this study if beans and lentils were used instead of soy and gluten?
• Does the Eco-Atkins diet improve disease outcome?
• Does the Eco-Atkins diet extend life?
• Does the Eco-Atkins diet affect quality of life?
• Can these effects be attained through other diets that include some animal protein, more whole grains or more fat?
• Is the effectiveness of the Eco-Atkins diet affected by an individual’s level of insulin resistance?
• Can adding fish further improve the results of the Eco-Atkins diet?
• Can a further reduction in carbohydrates improve the results?
• Will you get these same results if the study is NOT funded by the soy industry?

In summary, the results of this study are interesting and encouraging, especially for those of us who think both carbohydrates and meat should be limited in a healthy diet. I very much look forward to future studies exploring this idea.

What concerns me most is the lack of marine omega-3 fatty acids (fish) in the Eco-Atkins diet, which could potentially improve cardiovascular measures even further. Fish is also important for cognitive health and may lower cancer risk.

I am also worried that a strictly vegan diet would not be feasible in the long-term for many Americans. Moreover, it is not necessarily the healthiest option available. Vitamin B12 deficiency is a particular concern, but could be addressed with supplements. Generally, however, I do not recommend relying on supplements for optimal nutrition.

Finally, this study was funded by a company that makes soy and gluten products. Personally I would have prefered to see these protein sources used in combination with other things such as beans and lentils. Many people question how much soy can be safely consumed and gluten intolerance is more common than ever, so wouldn’t it be interesting to know if there were safer alternatives? It really annoys me to see science being influenced by industry funding.

What do you think of the Eco-Atkins diet?

Go Nuts!

Have you ever noticed that some of your strongest food memories are of rich, fat laden meals shared with family and friends? According to new research, this may not be a coincidence. A study published last week in the Proceedings of the National Academy of Sciences demonstrates that digesting fatty foods enhances memory consolidation using the same neural pathway as emotional learning.

This finding has far reaching implications for cognitive therapies to fight over-eating, but may also suggest new, easy to implement strategies for memory enhancement. Pistachios anyone?

In the study, rats being trained on memory tasks were administered a substance called oleoylethanolamide (OEA) that normally increases in the gut after the ingestion of dietary fat (not carbohydrate or protein). Several days later, the rats given OEA performed better on the tasks than rats that were not, demonstrating enhanced learning.

To determine the neural pathway involved in this effect, the researchers chemically blocked signaling in the region of the brain that receives neural inputs from the gut (solitary nucleus), which abolished the effect of OEA. Next they selectively blocked neural transmission between this region and another region of the brain that has been shown to be critical for emotional learning (amygdala). This also eliminated the memory enhancement effect of OEA, indicating that emotional memory and memory enhancement from fatty food ingestion share the same neural network.

These findings may partially explain the emotional component that is often associated with chronic over-eating, something that frequently involves learned habits triggered by emotional situations.

However, OEA does more than enhance memory. It is also critical in feelings of satiety after a meal (decreasing hunger) and has been implicated in controlling body weight. Is it possible this new information could be harnessed for the power of good?

Low-fat diets have proved to be a colossal failure for both health and weight loss, partially because they encourage over-consumption of starchy (usually refined) carbohydrates. Moreover, vegetable and fish oils are protective against many chronic diseases that plague Western culture. Regularly seeking healthy fats in your diet can help control hunger, promote weight loss and lower risk of disease. But it now seems that healthy fats could also be a useful tool in overcoming emotional eating, a problem more complex than the standard weight gain that comes from 21^st century living.

Another interesting corollary of this study is that fat (specifically oleic acid, a healthy fat found predominantly in olive oil and nuts) may enhance learning and memory. Since the benefits of OEA were only evident when it was administered at the time of or immediately after training, the next time you study or prepare for a presentation you might want to have some nuts around to snack on. Almonds, cashews, hazelnuts, macadamia nuts, peanuts, pecans and pistachios are highest in oleic acid.

Are you interested in foods that could provide cognitive enhancement?

Vegetables

Most scientists agree that diet plays an important role in heart disease, but until now there has been no comprehensive analysis of which dietary factors most strongly affect disease outcome. A new meta-analysis published in the Archives of Internal Medicine reviews six decades of research (1950-2007) to assess how different dietary factors affect heart disease. Vegetables, nuts, “Mediterranean” and high-quality dietary patterns are strongly protective, while trans-fat, foods with high glycemic index or load and a “Western” dietary pattern were shown to be harmful.

The Study

This new study is unique for several reasons. First, the authors were only interested in factors that influenced heart disease directly, not simply heart disease risk factors such as cholesterol levels. Also, emphasis was placed on high-quality studies designed to identify strong dietary associations (cohort studies and randomized controlled trials) with long periods of follow up (at least one year). They asked whether the studies they reviewed were consistent with other data such as epidemiological reports, and sought to establish a causal link between diet and heart disease outcomes. Another important goal of the analysis was to identify factors that lack sufficient evidence to be conclusive and require further research.

Results

In addition to identifying vegetables, nuts, high-quality and Mediterranean dietary patterns as being strongly protective against heart disease, they also found monounsaturated fats (e.g. olive oil), dietary folate (e.g. whole grains, not supplements), dietary vitamins C and E (not supplements), alcohol consumption (in any form) and omega-3 fatty acids from fish (not plants, e.g. flax) to be moderately protective.

Factors that were not associated with heart disease in this study were dietary supplements (e.g. vitamins C and E), total fat, saturated fats, polyunsaturated fats (from plants), meat, eggs and milk. It is important to note, however, that negative findings in this analysis are not necessarily indicative of a lack of causality. Rather, it may indicate insufficient data to observe a significant positive association.

Dietary Patterns

The authors point out that “only overall healthy dietary patterns are significantly associated with coronary heart disease” in the controlled trials, while “evidence for most individual nutrients or foods is too modest to be conclusive.” They suggest that the reason an association exists for dietary patterns and not individual nutrients is that patterns “have the advantage of taking into account the complex interactions and cumulative effects of multiple nutrients within the entire diet.” The authors recommend future trials test various dietary patterns for disease outcome, including cardiovascular disease and cancer.

Taking this further, most dietary factors that were shown to be protective when consumed as part of a healthy diet were not protective when taken in supplement form. This finding bolsters the argument that overall diet rather than individual foods or nutrients are the best strategy for protecting against heart disease. The authors conclude that their findings suggest “investigating dietary patterns in cohort studies and randomized controlled trials for common and complex chronic diseases such as coronary heart disease.”

Based on their analysis, the dietary pattern that best protects against heart disease is rich in vegetables, nuts, fish, healthy fats, whole grains, and fruit. Likewise, the worst dietary pattern consists of refined carbohydrates and artificial trans-fats. The lesson: the best diet consists of plants, fish and whole foods, while processed foods contribute to heart disease.

What about red meat and saturated fats?

Interestingly, there was insufficient data to conclude that red meat or saturated fats are harmful for the heart. This is not terribly surprising, since the data has always been inconsistent. However, I would point out that many studies have looked at the role of red meat and saturated fat in coronary risk and the outcome always shows either harm or no result. And as explained above, no result can be indicative of a lack of statistical power rather than lack of causation. Importantly however, I cannot recall a single study suggesting that red meat and saturated fat is actually good for you.

From this the best we can conclude is that red meat or saturated fat may be involved in promoting heart disease, but if they are the effect is likely to be less harmful than a diet of processed foods. Practically this means small doses of saturated fat may not do much harm when eaten as a part of an overall healthy diet. This is a fairly compelling argument for exercising moderation.

Conclusions

Before you run out and order a ribeye, keep in mind that heart disease is not the only debilitating chronic disease that plagues our culture. Red meat is also associated with several kinds of cancer. Likewise, refined carbohydrates are highly correlated with type 2 diabetes. Vegetables and whole grains are protective against these other diseases as well, and fish may play a role in protecting against neurodegenerative diseases.

The take home lesson is that both diet and disease are complex systems that involve innumerable factors in several different regions of the body. When choosing what to eat it is important that you consider the context of your overall diet and do not get caught up is single foods or a single disease threat.

Collards, Carrots and Lentils

Once you have everything you need to cook healthy meals, you are well on your way to a better healthstyle. But first let’s stop and make sure we know what a healthy meal looks like.

(This post is part five of the series How To Get Started Eating Healthy. Part one is Stock Your Pantry, part two is Essential Groceries, part three is Seasonal Shopping and part four is Stock Your Freezer. The recipe pictured is posted here.)

My goal here at Summer Tomato is to help you permanently adopt healthy eating patterns. Why? Because short-term weight loss diets, “cleansing” diets and ignoring your health completely will never do you any good. In contrast, healthy eating habits can add years and in some cases decades of high-quality time to your life.

I am not being sensationalist. The data is very convincing that your eating habits are the most important factor in your long-term health.

For many people the first big step in getting healthy is losing weight, and this means eating better and eating less. But my advice is generally the same (with a few exceptions) if you are not overweight. Healthy eating is the same for everyone–eating for fat loss and eating for health and longevity are the same thing.

How can you permanently eat better?

You cannot expect to let yourself go hungry and stick to that eating plan forever. It is therefore critical that you get the most out of your meals by making sure they have enough nutrients and flavor to keep you satisfied. I would go so far as to say you should love the food you eat and should walk away from it not wanting another bite. With balanced meals and wonderful ingredients, you can feel this way about what you eat.

Your body needs many things to function properly. It runs on complex carbohydrates, vitamins, fats, fibers, minerals, proteins and probably many more things we have not yet discovered. If you follow some trendy diet that encourages you to eliminate one or more of these, your body will feel deprived and ultimately find a way to get what it wants (usually in binge form). So let’s forget the starvation option and instead choose foods that give us all the nutrients we need. What we will reduce (not eliminate) are foods with fewer nutrients, the ones your body can be happy without. These foods will be addressed in a future post.

The best strategy is to give yourself a steady supply of what your body needs throughout the day. Every day. And because scientists have been unable to replicate a healthy diet with a pill, we need to focus on eating food. Real food. The kind that comes from the earth, not from a drive-thru.

The following is a guide to creating a perfect, healthy meal from food. It is only meant to be a blueprint, not a rigid plan. But I feel it is important to spell this out at the beginning because it is so different from how most people eat. I can assure you that it is very doable and more than satisfying. I eat this way, and I can say without hesitation that food is my favorite part of my day.

Eat Your Vegetables

Size Matters

As I alluded to in my post on seasonal shopping, the bulk of your diet must be vegetables if you hope to permanently lose weight and avoid heart disease, diabetes, cancer and dementia. The science is very clear on this point. If you do not like vegetables, I suggest you try and learn to like them. Chances are you have not eaten many high-quality vegetables from your local farmers market or that the ones you have tried were not prepared very well. Keep trying! Explore different recipes. Try different vegetables at high-end restaurants. Go out of your way to find vegetables cooked a way you like.

Here are some tips on learning to love foods you don’t like.

I recommend finding a friend who loves to cook and inviting him or her to explore your local market together–the enthusiasm of a chef at a farmers market can be contagious! You could even volunteer to help make a meal afterward with the fresh ingredients you found. It is amazing how quickly a kitchen becomes demystified when you spend a little time in one. Start with simple recipes. Delicious food does not have to be complicated if you cook with wonderful ingredients.

To reiterate, your first task is to increase your vegetable intake. Aim for about half of your (medium-sized) plate to be covered in vegetables. Make this happen for both lunch and dinner. If for whatever reason your choice of meal makes this difficult, try to get at least some green on your plate. Adding kale or spinach to whatever you’re making is usually pretty easy.

Diversify

You also want to try to get as much diversity as you can in the types of vegetables you eat. If you have seen those obnoxious lists of “superfoods,” you may have started to realize that any fruit or vegetable can be considered super. The fact is that all vegetables have some unique benefit and you maximize your health by eating many kinds of them, not by eating a lot of one kind. I try to mix up my weekly shopping cart to reflect the diversity of the farmers market, and I usually try to buy something I have never eaten before.

One wonderful thing about seasonal shopping at your local farmers market is that vegetables and fruits come and go pretty quickly, so diversity comes with the territory.

Smart Protein

I mentioned above that it is important to feel satisfied by your meals, and protein can go a long way in helping you achieve this. However, there are many misconceptions about protein, particularly regarding how much and what kinds you should eat.

I’ll start by saying that virtually no one in the Western world is protein deficient. It is relatively easy to get the protein your body needs to maintain its muscle mass. I do not recommend counting protein grams unless you are a professional body builder, in which case this probably isn’t the best website for you.

Despite what some people may say, many vegetables and grains contain protein. For instance, a cup of brown rice has 5 grams of protein. A cup of black beans has 15 grams of protein (and 20% of your daily iron). Some will argue that these are not “quality” sources of protein because they are not “complete proteins,” meaning that they are lacking in some essential amino acid. However, this argument is irrelevant if you follow my advice above and enjoy diversity in your diet. Yes, if all your protein comes from brown rice then you may be deficient in lysine, but presumably you are eating more than just brown rice and the rest of your food will easily make up the difference.

Getting all your protein is important, but since it is relatively easy to get I find the biggest value of protein is helping you feel satisfied after a meal. Protein digests more slowly than carbohydrates and can help you feel full longer. From this perspective, it matters very little where your protein comes from.

Personally I try to get my protein from beans, eggs or fish, because they offer more than just protein. Beans are a great source of fiber and iron. Eggs are a perfect size and are rich in vitamins. Fish has wonderful oils that have been shown to protect your heart and brain.

I’m fairly neutral on poultry and red meat in reasonable quantities.

Intact Grains

Despite what disciples of Dr. Atkins may say about carbohydrates (a lot of which I agree with), intact whole grains are essential to a healthy diet. Unfortunately, real whole grains are not very easy to come by in our culture. I have explained before, there is a tremendous difference between an intact whole grain that still looks like a grain and the “whole grains” in Lucky Charms that have been mutilated then reassembled. Real, intact grains digest slowly and are an essential source of fiber, vitamins, minerals and other wonderful things.

Like protein, whole grains should comprise about a quarter of your plate. However, since whole grains are rather difficult to get, I usually choose to make intact grains the bulk of my breakfast, and usually incorporate other grains such as brown rice or quinoa into either lunch or dinner. These will also go a long way to increase the satisfaction you feel from a meal.

Healthy Fats

One of the reasons the low fat diet from the 20th century failed so miserably is that it did not account for the necessity of healthy fats. Oils from plants and fish are critical for protecting against disease. And, like protein and grains, they contribute greatly to how satisfying your meal is.

Because fats have a high caloric density, a little really goes a long way and there is no definitive space on your plate that I allot to them. However, generally I recommend dressing or cooking all your vegetables in minimally processed oil, such as cold-pressed olive oil. I also recommend cooking with nuts (many different kinds, of course) regularly and enjoying avocado and other oily plants frequently.

Fish provide a different kind of oil than plants, and both are important. But if you are eating substantial amounts of fish you should be aware of the dangers of mercury contamination.

Conclusion

Strive to eat a diverse array of fresh vegetables, healthy proteins, intact grains and plant and fish oils as a part of your daily healthstyle, particularly in the meals you have control over. However, this is not something you should approach as all-or-none. Any meal can be made more healthy by adding these ingredients, and it is worth it to work them in if possible.

But most important, be sure that whatever you eat you enjoy. None of this is “diet food” and all of it should make you happy.

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