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Page 1: Eat real food. Avoid processed food. Cook more. · Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended

© Ellen Vora, MD. Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice.

DitchtheDietEllenVora,MD

Eatrealfood.Avoidprocessedfood.Cookmore.Dieting…wheredoIevenbegin?

- Firstofall,anyonewhohasevertriedtodiethaslikelyexperiencedfrustration,hunger,desperation,bingeingandtheyo-yoeffectwheretheyendadietinafitofravenoushunger,andultimatelygainbacktheweighttheylost…andthensome.Youhaveprobablyheard“dietsdon’twork.”Sothenwhatissomebodysupposedtodotoloseweight?Doctorssay,“exerciseandwatchwhatyoueat.”But,whatdoes“watchwhatyoueat”evenmean?Ifyou’reboldenoughtoaskforclarification,theymayfumblearesponselike:“youknow…um…eatmorefruitsandvegetables,”orperhaps“cutdownonfat,”orthemostenlightenedamongthemwillsay,“cutdownonprocessedfoods.”Soyoutrythat,andstill,nolastingweightloss.Whatgives?

Whocanyouturnto?

- Doctorsreceiveverylittleeducationonnutrition.- Whiletherearesomeexcellentregistereddieticians,insomecasestheirinstitutionshaveindustryties,so

theirviewsmaybeshapedbythefoodindustryagenda.- Sowhocanyouturntofortrustedadvice?Isuggesthealthcoaches.- Seekoutahealthcoachwithabackgroundfreeoffinancialtiestothefoodindustry,andonewhose

educationspannedmanydifferentfoodphilosophies.Hereare2greatoptions:o GraduatesfromtheInstituteforIntegrativeNutrition:www.integrativenutrition.como www.rise.us(adigitalhealthcoachingplatform)

Whensomeone(includingme)tellsyouwhattoeat,beveryskeptical

- Thedebateonwhat’sthecorrectwaytoeat(vegan,paleo,lowfat,lowcarb,ketogenic,Mediterranean)hasreachedfeverpitch.

- Choosingwhattoeathasvariousconsiderations:ethics,environment,taste,allergiesandintolerances,religion,cost,convenience,familyconsiderations,andgeneralhealth.

- Therearealsoancestralfactorsthathavebeenlargelyignored:areyouofMediterraneandescent?OrperhapsIndian,Asian,NativeAmerican,NorthernEuropeanorAfricandescent?Thislikelymattersindeterminingwhatdietisoptimalforyou.There’snoone-size-fits-alldiet.

- TheMediterraneandiethasthemostevidencebackingit,butIdon’tthinkit’snecessarilythebestdietforeveryone.AnditispossibletoeatpoorlywhiletechnicallyadheringtotheMediterraneandiet.Somediets,suchasthepaleodiet,arejustbeginningtoberesearched.

- However,Iwouldarguethattheresearchisnotthathelpfulinguidingourchoices.- Todrownouttheconflictingresearchpapersandmediaheadlines,here’swhatIuseasmycompass:

o Listentoyourbody–howdoyoufeelwhenyoueatthisfood?o Isitrealfood?o Didwe(moreorless)evolveeatingthis?

EatRealFood:

- Myoveralleatingphilosophy:o Eat.Real.Food.

- Andconversely,don’teatfakefood.- Simple,butnoteasy.

What’sRealFood?

- Askyourself:diditgrowinthegroundorwasitahealthyanimal?- Realfoodincludes:

o Allvegetables

Page 2: Eat real food. Avoid processed food. Cook more. · Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended

© Ellen Vora, MD. Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice.

o Starchytubers(sweetpotatoes,taro,yucca,plantain)o Pasturedmeatsandorganmeats(eateverypartoftheanimal)o Free-rangeeggsandpoultry(eattheyolk!)o Wildfish(smallfish(e.g.,sardines,anchovies,salmon)arebetterthanlargefish(e.g.,tuna,

swordfish))o Fermentedfoods(sauerkraut,beetkvass,kimchi,miso)o Plentyofnaturalfats(grass-fedbutterandghee,coconutoil,MCToil,oliveoil,avocados)o Bonebroth,chickenbroth,fishstocko Nutsandseedso Chocolateo Allfruit(butifyou’rerehabilitatingyourdiet,bettertoaimforlesssweetfruitslikeberriesand

grapefruit)o Sproutedriceandlegumes(ifyouchoosetoeatgrainsandlegumes)o Full-fatdairy(ifyouchoosetoeatdairy,the“realest”formofitisfull-fat,unpasteurizeddairy)

What’sNotRealFood?

o Allprocessedfoodso Conventionalmeat,dairyandpoultry(oftenfedhormonesandantibiotics)o Artificialfats

! Transfats! Industrialseedoils(e.g.,canolaoil,cornoil,soybeanoil,saffloweroil)

o Highfructosecornsyrupo Artificialsweetenerso Processedsoyo Conventionalflour(whichcontainsaproblematiccompoundcalledglyphosate)o Skimmilko Anythingwithpreservatives,foodcoloringor“naturalflavor”

DroptheFat-Phobia

- It’stimetodropfat-phobia.Wewerewrong.Saturatedfatandcholesterolarenotthecauseofheartdisease(withsomerareexceptions,suchasfamilialhypercholesterolemia).

- Heartdiseaseismoreconsistentlytiedtosugarandartificialfatconsumption.- Low-fatdietshavedefaultedustohighsugarandcarbohydrateconsumption,withaconcomitant

increaseindiabetesandheartdisease.- Fatcontainsvitaminsandregulatesappetite.Stopfearingfat.- Cholesterol(nottechnicallyfat,butrelatedinourcollectiveunconscious)isessentialforcellmembranes,

properneuronfunctionandhormoneproduction.

CountChemicals,NotCalories

- Countingcaloriesisbasedonbadscience.- Weusedtothinkallcalorieswerecreatedequal,andwethoughtweightlosshadtodowithasimple

equation:caloriesin–caloriesout=totalcalories(andifyourunadeficit,youloseweight)- Asif!Itismuchmorecomplexthanthat.Variousfactors,includingthefoodsweeat,howmuchweeat,

andeventhebacteriainourguts,determineourappetite,satiety,metabolismandfatdistribution.- Ifyouwanttobehealthyandloseweight,asChrisKressersays:“countchemicals,notcalories.”- Inpractice,thismeansthateatingcaloriedenserealfoodssuchasgrass-fedgheeormacadamianutswill

promotehealthbetterthanzerocaloriesodasmadewithartificialsweeteners,or100-caloriesnackpacks.

ThinkAboutNutrient-Density

- Wehaveanationaleatingdisorder—wethinkaboutfoodascalories.Wethinkifsomethingisdelicious,itmustbe“fattening.”We’velosttouchwithfoodasnutrition—notjustcalories,butalsovitamins,mineralsandmacronutrients(fat,carbohydrateandprotein).

- Shiftawayfromthinkingoffoodascaloriesandtowardfoodasyouropportunityfornutrition.

Page 3: Eat real food. Avoid processed food. Cook more. · Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended

© Ellen Vora, MD. Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice.

- Inthebestofcircumstances,it’sactuallydifficulttogetallthenutritionweneedfromaday’sworthoffood.Ifwetheneat“emptycalories”andprocessedfood(anutritionalwasteland),youhavetheAmericanconundrum:we’reoverfedandundernourished.

- Thinkofprocessedfoodasnutritionalopportunitycost.Instead,aimformaximalnutritionperbite:o Eatthemostnutrient-densefoods(organmeats,spices,veggies,pasturedmeats,healthyfats)o Eatabalanceofnutrients:

! Yourplateshouldbeabouthalfvegetables,aquarterproteinandaquarterstarch! Eatarainbowofdifferentcoloredfoods! Catchthemoreelusivenutrients:

• Eatdulseforiodine• Eatpumpkinseedsandcacaoformagnesium• Eatwildcold-waterfattyfishforomega-3fatsandvitaminD• EateggyolksforBvitaminsandcholine• Eatorganmeats—they’reaveritablemultivitamin

AvoidtheDrug-LikeFoodsThisisthemissingingredientformanypeoplewhocontinuouslyovereatandgetstuckinarestriction-bingecycle.

- Abstinenceo Avoidthedrug-likefoods,whicharesugar,gluten,dairyandflavoradditives(e.g.,MSG).o Sugarhitstherewardcircuitryofthebrain,whileglutenanddairybreakdownintoopiate-like

substancescalledgluteomorphinandcasomorphine.Ifyoususpectyouare“addictedtofood,”thismightbetheexplanation.

- EatRegularMealso Aimfor3mealsand2snacksperday.Thishelpskeepbloodsugarstable.o Youwanttosendasignaltoyourbrainthatyou’reinastateofabundance,notstarvation(which

cantriggerovereating).o Eatwhenyou’rehungry,stopwhenyou’refull.

- AvoidAllFormsofRestriction*o Restriction-->binge-->restriction-->binge-->…o Youcanonlytrulystoptherestriction-bingecyclebystoppingrestriction.o Avoidingrestrictionmeanseatingregularmealsandconsumingplentyofprotein,healthyfatand

carbohydrate.Besuretoeatdelicious,satisfyingfoodateverymeal.*Youmayhavenoticedaninherentcontradictionbetweenstep1(abstainfromsugar/gluten/dairy/MSG)andstep3(avoidrestriction).Wehavetonavigatethisdelicatebalancecarefully.Restrictionisanunhealthymentalandphysicalstatethatbegetsbingeing.However,Istillencourageyoutoabstainfromthedrug-likefoods.Wearetryingtore-establishhealthyhungerandsatietysignals.Thedrug-likefoodsoperateasaddictivesubstancesintherewardcircuitryofthebrain,overridinghungerandsatietysignals,andtherebyunderminingoureffortstore-establishproperhungerandsatietysignals.

- Sleepo Getenoughsleepeverynight.Thisisaround8hoursformostpeople.o Sleepregulatesthehormonesinvolvedinappetite,satietyandmetabolism.o Icannotemphasizethisoneenough.Adequatesleepisasignificantfactorinestablishinghealthy

hungerandsatietysignals,anditisoftenoverlooked.Makeitapriority.Makeitthepriority.- StabilizeBloodSugar

o Bloodsugarfluctuationscanprecipitateovereating.o Takeaspoonfulofcoconutoil3timesaday(uponwaking,intheafternoon,beforebed).o ConsiderstartingyourdaywithcoffeeorteablendedwithbutterandMCToil.o Alwayshaveasnackhandy(e.g.,nuts,hard-boiledegg,wildsalmonjerky,grass-fedbeefjerky,

darkchocolate,almondbutter),soyoustayontopofbloodsugarwhileyou’reonthego.Don’twaitforthebloodsugarcrash—preventitwithawell-timedsnack.

- Relaxo Practicerelaxationandstressmanagement(yoga,meditation,breathingexercises).

Page 4: Eat real food. Avoid processed food. Cook more. · Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended

© Ellen Vora, MD. Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice.

o Considergettingenergywork(acupuncture,craniosacraltherapy,Reiki).o Eatmindfully:chewthoroughlyandavoiddistractionswhileyoueat(TV,computer).o Lookawayfromthephoneandwakeuptoyouandyoursurroundings:listentoyourbody,your

emotionsandyourlovedones.o Ingeneral,slowdownandlisten.o Shiftyourrelationshiptofoodawayfromself-punishmentorself-sabotageandtowardeatingas

anactofself-careandself-love;stopbattlingwithyourself.o Imbueyourrelationshiptoyourself,yourbodyandyourfoodwithloveandradicalacceptance.

- OptimizeNutritionalStatuso Subtlemicronutrientdeficienciescanincreaseappetite(yourbodyistryingtogetwhatit’s

missing).o Eatanutrient-densedietofrealfoodtoensureexcellentnutrientstatus.

MakeEatinganActofRadicalSelf-LoveandGoEasyonYourself- Youarenotinabattlewithyourbodyoryourappetite- Honoryourbody’sappetites,buthelpitdiscernbetweenintuitiveappetiteanddrug-craving- Trytoadheretothisapproach80%ofthetime,anddon’tlosesightofwhatmakeslifefulfilling(social

connection,community,enjoyment).AsChrisKressersays,sometimesit’sbettertoeatthewrongfoodwiththerightattitudethantheotherwayaround.

HealtheGut

- Ourguthealthhasadirectimpactonourappetiteandmetabolism- Here’showtohealthegut:

o Avoidwhatirritatesthegut! Gluten,sugar,industriallyprocessedvegetableoils,artificialsweeteners,+/-dairy

o Addinwhatsoothesthegut! Takeaprobioticdaily–IrecommendPrescriptAssistformostpeople! Consumefermentedfoods–IrecommendHawthorneValleyFarmssauerkraut! Eatstarchytubers,suchassweetpotatoes,plantain,taro,yucca! Consumebonebrothorcollagenpowder

o Createtheconditionsfortheguttoheal! Stressmanagement! Squattypotty–www.squattypotty.com! Acupuncture,yoga,meditation,breathe,journal,spendtimeinnature,unplug

TroubleshootingWhattoEatforBreakfast

- Breakfastisnotoriouslychallenging.Mytypicalpatient’sbreakfastrangesfrom“nothing”to“coffeewithskimmilkandsplenda.”

- Manyofourmoderndayills(stress,anxiety,difficultywithattentionandfocus,insomnia,fatigue)areintimatelyrelatedtobloodsugarinstability.Eatingabreakfastrichinproteinandfatandlowinsugarandrefinedcarbscansetyouupwithstablebloodsugarfortherestoftheday.

- Breakfastrecommendations:o Eggs–ifyouhavetime,cookthemfresh.Ifyoudon’t,makeabatchofhard-boiledeggsoverthe

weekend,leavethemintheshell,andput1-2eggsinabaggietotakewithyoutoworko Organicpre-cookedsausages–widelyavailable,andittakeslessthanaminutetoheatitupin

themicrowaveo Oatmeal–ifyoutolerategrains,oatmealisagreatchoice.Youcanmakeitmorebloodsugar

stabilizingbyaddingfatandproteinintheformofnuts,groundflaxseed,coconutoil,shelledhempseedsorcream(ifyoutoleratedairy)

o Nuts–ifyoureallydon’thavetimetositdownandeatfood,attheveryleast,carryabaggieofnutsthatyoucansnackonearlyintheday

Page 5: Eat real food. Avoid processed food. Cook more. · Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended

© Ellen Vora, MD. Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice.

o “BulletproofCoffee”–ifyoudrinkteaorcoffeeinthemorning,considerstirringorblendingsomegrass-fedbutterorgheeandsomethingcalledMCToil(mediumchaintriglycerideoil,aformofrefinedcoconutoil)intothebeverage.Thiswillprovideyouwithagoodbolusofhealthyfatsfirstthinginthemorning.

OrderingTake-Out- Inaperfectworld,we’dbecookingallourownfood.Butrealistically,weareoftenorderingtake-outand

delivery.- Therearebetterandworserestaurants,andbetterandworseoptionsonanygivenmenu.- OnthelastpageisalistofsomeNYCrestaurantsthatofferrealfood.Noguaranteesthateverythingon

themenuisrealfood,butatleastit’sastart.- Menutricksandtips:

o Ordersimplefoods,suchasapieceoffishormeatwithveggiesandpotatoeso Ifnothingonthemainmenuappealstoyou,considerorderingavarietyofsideso Ifnothingonthemenuseemslikerealfood,askifthekitchencanmakeapieceofmeatorfish

withveggies,orifyou’revegetarian,askifthey’rewillingtomakeyouriceandbeanso Assumethateverythingatarestaurantiscookedinindustrially-processedvegetableoil(whichis

inflammatory)o Assumethatmanythingsatarestauranthavethefollowingflavor-enhancingingredientsadded:

! Sugar,Dairy,MSG,Soysauce,Gluten- Exploretheworldofmealdeliveryservices:

o www.petespaleo.com

Snacking

- Snackingisanothercommonchallenge.Try:o Nutso Darkchocolate

! Lookfororganic,withoutGMOsoylecithin,withoutdairy,madewithrealcacaobeans,withhighcacaocontentandlowinsugar.

o Fruito Kefiroryogurto Veggies&Hummuso WildSalmonJerky(VitalChoice)o Grass-fedjerky(Epic,Tanka)o Coconutmilkfromajuicebaro Spoonfulofcoconutoil

Travel

- Thekeytoeatingwellwhileyoutravelisplanningahead- Packplanesnacks- Packgrass-fedjerky(Epic,Tanka)- WildSalmonJerky(VitalChoice)- Baggiesofnuts

Cooking- Makecookingrealistic:cookalargevolumeoffoodonceaweek,putintupperware,eatatlunch/dinner- Trytoadheretothis80%ofthetime,anddon’tlosesightofwhatmakeslifefulfilling(socialconnection,

community,enjoyment).“Sometimesit’sbettertoeatthewrongfoodwiththerightattitudethantheotherwayaround”–ChrisKresser(authorofThePaleoCure)quotinganancientChinesesaying

Page 6: Eat real food. Avoid processed food. Cook more. · Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended

© Ellen Vora, MD. Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice.

RealFoodResources- Seafood:VitalChoicewww.vitalchoice.com- PasturedMeats&OrganMeats:USWellnesswww.grasslandbeef.com- Grass-FedBeef:TXBarOrganicswww.txbarorganics.com- FermentedFoods,BoneBroth,Soup,Dairy:www.wisechoicemarket.com- Oils,Butter,CookingFats:Fatworkswww.fatworksfood.com- CoconutOil:TropicalTraditionswww.tropicaltraditions.com- CoconutMilk&CannedVegetables:NativeForest- SproutedRice&Legumes:TruRootsOrganicGerminatedRice&SproutedLentils(Amazon)- Pre-MadeBoneBroth:Brodo,Hudson&Charles,NourishingNewYorkwww.nourishingnewyork.com,

www.thesimplebroth.com- Soup:NonaLimwww.nonalim.com- BulletproofCoffee,MCTOil:www.bulletproofexec.com/bulletproof-mind- Ingredients/Produce:Gotoyourfarmersmarket,joinaCSAthatdelivers,ortryQuinciple–Farm-fresh

producedeliveryserviceinNYC,$50/week-www.quinciple.com- MealDeliveryServices:www.petespaleo.com,www.eattribal.com,www.premadepaleo.com- Grocery:www.thrivemarket.com- Bookrecommendation:ThePaleoCurebyChrisKresser- Chocolate:lookfororganic,withoutGMOsoylecithin,withoutdairy,madewithrealcacaobeans,withhigh

cacaocontentandlowinsugar.o ChocolateRecommendations:Granada,EatingEvolved,AntiDote,AlterEco,Theo,Artisana,Vital

Choice

GoodFoodonaTightBudgethttp://www.ewg.org/goodfood/RealFoodFreeCookbookhttp://freejerfcookbook.com/RestaurantsandTake-OutOptionsforRealFoodinNYC:

- HuKitchen(paleo,nearunionsquare;trychickenwithsidesorbowlwithHuJoeandveggiemash)- Foragers(Chelsea,Dumbo,grocerystore,winestoreandrestaurant)- PeacefoodCafé(vegan,nearunionsquare)- Ellery’sGreens(greenwichvillage)- Westville(American,westvillage,Chelsea,eastvillage,Tribeca;trymarketsidesplate–choose4market

sides,e.g,kale,broccoli,artichokeheartsnocheese,polenta;orgetthetrout)- NourishKitchen(westvillage)- Taim(WestVillage,Soho;gluten-freefalafel–getthemixedfalafelplatter,butsubstitutebeetsand

carrotsfortaboulehandIsraelisalad,anddon’teatthepita)- Souen(UnionSquare,EastVillage,Soho;misosoup,chefsalad,planetplatter)- MasFarmhouse(WestVillage)- MarketTable(WestVillage)- BlueHillStoneBarns(WestVillage,Westchester)- EstiatorioMilos(Midtown,Mediterranean)- Thalassa(Tribeca)- StAnselms(steakhouseinBrooklyn)- CandleCafé(UWS)- WildRestaurant(WestVillage)- KombuRamen(glutenfreesoupwithricenoodles;eastvillage/unionsquare)- WeiWest(Tribeca;glutenfreeChinesefood)- DigInn(Paleofastcasualfood;midtown,unionsquare,Tribeca,worldfinancialcenter)- Sushi(avoidsoysauce,avoidgingerdressing,avoidsauces–eatuni,yellowtail,salmon,ikura,rice,miso

soup(notalwaysgluten-free))- Juicebars(JuicePress,OrganicAve,Liquiteria,Melvin’sJuiceBar,OneLuckyDuck,TinyEmpire,etc)- SweetPea(Flatiron)

Page 7: Eat real food. Avoid processed food. Cook more. · Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended

© Ellen Vora, MD. Do not duplicate or distribute without permission. This content is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice.

- AngelicaKitchen(EastVillage)- FetteSau(BBQinWilliamsburg,sameownersasStAnselms)- MightyQuinns(BBQinlowereastside)- Momofuku(EastVillage;tryporkbellyandbeeftendons)- Takashi(WestVillage;tryorganmeats)- GreatNorthernSpyCompany(EastVillage)- MermaidOysterBar(Soho)- KleeBrasserie(Midtown)- HundredAcres(Soho)- Kafana(EastVillage)- Kristophe(Brooklyn;tryVenisonburger)- Juventino(ParkSlope)- Sauce(LES)- Hearth(EastVillage)- Brodo(EastVillage;bonebrothshop)- Palma(WestVillage;Italian)- Landmarc(Tribeca;trybonemarrowwithoutthebread,Brusselssprouts)- Macelleria(Meatpacking;trybonemarrowwithoutthebread,rosemarypotatoes,greens)- PaloSanto(ParkSlope)- ChelseaMarket(Chelsea)

o Friedman’sLunch(gluten-freechickensoup)o TheLobsterPlace(unimaki,yellowtailscallion,avocadoroll)o BeyondSushi(vegansushi)o TheGreenTable