Are you confused by all of the seemingly conflicted nutritional advice out there? I know I am, and I’m a doctor. I actively seek out nutritional information and for the most part feel like I am well informed. Yet I still question my food choices. Both what I chose to eat for myself and my family but also what I recommend to patients.
I make note of being doctor although medical education regarding diet and nutrition is exceptionally poor. In four years of medical school, I had one half-day of instruction on nutrition and seven questions on an exam. I did get those seven questions 100% correct, but that was almost 20 years ago now, and nutrition advice has evolved since then.
I found nutrition information fascinating then, and I still do now.
Everywhere you look, a different expert is proclaiming a specific way of eating as the best way, the only way.
I think there are many approaches to a healthy diet and what works for one person may not work for the next. So, I try not to overthink it.
As Michael Pollan says, eat real food, mostly plants, not too much. As long as I eat real food, I think the particular choices may not be as important. For me, I think a plant based diet makes the most sense and is the most sustainable. But does that mean I should be entirely vegan? I don’t think so.
Certainly a healthy diet is an essential part of a healthy lifestyle. Scientific research says four health behaviors, which are a wholesome diet, regular exercise, maintaining a healthy weight and not smoking, have an enormous impact on health and longevity. If you can maintain those four behaviors, you will be able to avoid up to 80% of chronic disease, adding both years to life as well as more active and enjoyable life to those years.
There is an incredible study going on at Harvard, called the Harvard study of adult development. It started in the 1930s and is still going on today more than 75 years later. It followed 724 men from two very different backgrounds. One group was composed of Harvard students, and the other was poor, underprivileged, boys from Boston’s inner-city.
Some of the original participants are still alive today in their 90s, and the study is now following the children from the initial group. This study tracked these men interviewing them, reviewing their medical records, talking to their wives and families to determine what factors resulted in health, happiness, and longevity. It wasn’t money, success or a healthy cholesterol level at age 50 that best predicted good health and happiness at age 80. Instead, it was how satisfied the men were with their relationships. Being more socially connected to family, friends, and community led to happier, healthier people who lived longer. Robert Waldinger is the current director of the study; you can listen to his TED talk here.
Another example of the remarkable power of relationships and community on health and longevity is known as the Roseto effect. Roseto is a small town in Northeastern Pennsylvania. In the 1960s, a local doctor realized there was an exceptionally low rate of heart disease in Roseto -virtually non-existent- compared to some of the surrounding towns.
The inhabitants smoked cigars, drank lots of wine, ate meatballs, sausage, and plenty of cheese, while being exposed to potentially toxic gasses and dust in the slate quarries, not exactly the usual recipe for good health.
However, the community was very close knit. The was no crime; people supported each other, meals were a reason to get together and celebrate. There was a strong work ethic with everyone in town working toward a similar goal, a better life for their children. Their children did go on to have more material things and traditional success but not necessarily a better life. As the supportive community began to break down the rates of heart disease and premature death increased, equalling the rates of the surrounding towns.
And, of course, there is the Mediterranean diet with its associated health benefits. People living near the Mediterranean Sea live longer and healthier lives than in other parts of the world. Their diet is often promoted as being one of the healthiest. It consists primarily of real food – fruits, vegetables, nuts, fish, olive oil, and even some red wine.
But it’s not just the diet that results in exceptional health and longevity; it’s the lifestyle. People eat well, savor and enjoy their food. They are social and connected to their community. They spend time outside, moving, engaged in activity that they enjoy. A British cardiologist, Dr. Aseem Malhotra, is making a film about Pioppi, Italy called the Pioppi protocol. Pioppi is on the Mediterranean, and it’s inhabitants are among the world’s healthiest, often living into their 90s. In his film, Dr. Malhotra contends that it is the Mediterranean lifestyle, not just the diet that cultivates good health.
I say this not because diet is unimportant. Healthy food choices are essential for healthy living. The better I eat, the better I feel. And of course, science confirms the relationship between healthy food, normal weight and good health. I remind myself of these examples so that I don’t get too hung up on my particular food choices.
Diet and exercise are what usually come to mind when people think of healthy lifestyles. But, there is more to it than that. Harvard’s study of adult development, Roseto, Pennsylvania and Pioppi, Italy are good reminders of the other important contributors to healthy living.
If healthy, supportive relationships can offset some of the known detrimental effects of poor lifestyle choices like smoking cigars and eating a lot of meat and cheese as illustrated by the Roseto effect, imagine what they could do for someone who does eat well.
I eat well most of the time because I feel better when I do. But, I indulge. And when I find myself obsessing over minor details I remind myself of the bigger picture. There is more than one way to take care of yourself, which in addition to eating well and exercising includes stress reduction, plenty of sleep, and nurturing your relationships. Within and between each of these categories, there is give and take. Some days the good work I do in one category may make up for a subpar performance in another. But I strive to reach a minimum goal in each group every day.
I put together a daily wellness checklist to remind, motivate and inspire me to achieve within each of these areas. Click here if you’d like a copy. It helps me to stay on track and gives me a little win when I check off an activity as completed.
Dr. Kate Killoran is a board-certified OB/GYN with 15+ years of clinical experience and a breast cancer survivor. Medical school, residency, and clinical practice educated her thoroughly about disease. What her medical education failed to teach her was how to be healthy and well. This she learned from her breast cancer diagnosis.
She practices what she preaches using her knowledge of health, wellness, and disease to help other women be healthy, happy, and well. She sees patients both in her office in beautiful Camden, Maine as well as online at www.drkatemd.com.