Posts Tagged ‘Diet’

Sex and the Mediterranean Diet

February 1, 2014

Blog # 139

Sexuality is a very important part of our human existence, both for purposes of procreation as well as pleasure.  Although not a necessity for a healthy life, the loss or diminution of sexual function may result in loss of self-esteem, embarrassment, a sense of isolation and frustration, and even depression. Therefore, for many of us it is vital that we maintain our sexual health. Loss of sexual function further exacerbates progression of sexual dysfunction—the deficiency of genital blood flow that often causes sexual dysfunction produces a state of poor oxygen levels (hypoxia) in the genital tissues, which induces scarring (fibrosis) that further compounds the problem.  So “use it or lose it” is a very relevant statement when it comes to sexual function, as much as it relates to muscle function.

Healthy sexual function for a man involves a satisfactory libido (sex drive), the ability to obtain and maintain a rigid erection, and the ability to ejaculate and experience a climax. For a woman, sexual function involves a healthy libido and the ability to become aroused, lubricate adequately, to have sexual intercourse without pain or discomfort, and the ability to achieve an orgasm.   Sexual function is a very complex event contingent upon the intact functioning of a number of systems including the endocrine system (produces sex hormones), the central and peripheral nervous systems (provides the nerve control) and the vascular system (conducts the blood flow).

A healthy sexual response is largely about adequate blood flow to the genital and pelvic area, although hormonal, neurological, and psychological factors are also important.  The increase in the blood flow to the genitals from sexual stimulation is what is responsible for the erect penis in the male and the well-lubricated vagina and engorged clitoris in the female. Diminished blood flow—often on the basis of an accumulation of fatty deposits creating narrowing within the walls of blood vessels—is a finding associated with the aging. This diminution in blood flow to our organs will negatively affect the function of all of our systems, since every cell in our body is dependent upon the vascular system for delivery of oxygen and nutrients and removal of metabolic waste products.  Sexual dysfunction is often on the basis of decreased blood flow to the genitals from pelvic atherosclerosis, the accumulation of fatty deposits within the walls of the blood vessels that bring blood to the penis and vagina.

Sexual dysfunction may be a sign of cardiovascular disease. In other words, the quality of erections in a man and the quality of sexual response in a female can serve as a barometer of cardiovascular health. The presence of sexual dysfunction can be considered the equivalent of a genital stress test and may be indicative of a cardiovascular problem that warrants an evaluation for arterial disease elsewhere in the body (heart, brain, aorta, peripheral blood vessels).  The presence of sexual dysfunction is as much of a predictor of cardiovascular disease as is a strong family history of cardiac disease, tobacco smoking, or elevated cholesterol. The British cardiologist Graham Jackson has expanded the initials E.D. (Erectile Dysfunction) to mean Endothelial Dysfunction (endothelial cells being the type of cells that line the insides of arteries), Early Detection (of cardiovascular disease), and Early Death (if missed). The bottom line is that heart healthy is sexual healthy.

Many adults are beset with Civilization Syndrome, a cluster of health issues that have arisen as a direct result of our sedentary lifestyle and poor dietary choices.  Civilization Syndrome can lead to obesity, high blood pressure, and elevated cholesterol and can result in such health problems as diabetes, heart attack, stroke, cancer, and premature death.  The diabetic situation in our nation has become outrageous—20 million people have diabetes and more than 50 million are pre-diabetic, many of whom are unaware of their pre-diabetic state! It probably comes as no surprise that diabetes is one of the leading causes of sexual dysfunction in the United States.

Civilization Syndrome can cause a variety of health issues that result in sexual dysfunction.  Obesity (external fat) is associated with internal obesity and fatty matter clogging up the arteries of the body including the arteries which function to bring blood to the genitalia.  Additionally, obesity can have a negative effect on our sex hormone balance (the balance of testosterone and estrogens), further contributing to sexual dysfunction. High blood pressure will cause the heart to have to work harder to get the blood flowing through the increased resistance of the arteries. Blood pressure lowering medications will treat this, but as a result of the decreased pressure, there will be less forceful blood flow through the arteries.  Thus, blood pressure medications, although very helpful to prevent the negative effects of hypertension—heart attacks, strokes, etc.—will contribute to sexual dysfunction.  High cholesterol will cause fatty plaque buildup in our arteries, compromising blood flow and contributing to sexual dysfunction.  Tobacco constricts blood vessels and impairs blood flow through our arteries, including those to our genitals. Smoking is really not very sexy at all!  Stress causes a surge of adrenaline release from the adrenal glands. The effect of adrenaline is to constrict blood vessels and decrease sexual function.  In fact, men with priapism (a prolonged and painful erection) are often treated with penile injections of an adrenaline-like chemical.

A healthy lifestyle is of paramount importance towards the endpoint of achieving a health quality and quantity of life.  Intelligent lifestyle choices, including proper eating habits, maintaining a healthy weight, engaging in exercise, adequate sleep, alcohol in moderation, avoiding tobacco and stress reduction are the initial approach to treating many of the diseases that are brought on by poor lifestyle choices.  Sexual dysfunction is often in the category of a medical problem that is engendered by imprudent lifestyle choices.  It should come as no surprise that the initial approach to managing sexual issues is to improve lifestyle choices.  Simply by pursuing a healthy lifestyle, Civilization Syndrome can be prevented or ameliorated, and the myriad of medical problems that can ensue from Civilization Syndrome, including sexual dysfunction, can be mitigated.

In terms of maintaining good cardiovascular health (of which healthy sexual function can serve as a proxy), eating properly is incredibly important—obviously in conjunction with other smart lifestyle choices. Fueling up with the best and most wholesome choices available will help prevent the build up of fatty plaques within blood vessels that can lead to compromised blood flow. Poor nutritional decisions with a diet replete with fatty, nutritionally-empty choices such as fast food, puts one on the fast tract to clogged arteries that can make your sexual function as small as your belly is big!.

A classic healthy food lifestyle choice is the increasingly popular Mediterranean diet.  This diet, the traditional cooking style of the countries bordering the Mediterranean Sea including Spain, France, Greece, Cyprus, Turkey, Southern Italy, and nearby regions, has been popular for hundreds of years. The Mediterranean cuisine is very appealing to the senses and includes products that are largely plant-based, such as anti-oxidant rich fruits and vegetables, whole grains, nuts, seeds and legumes.  Legumes—including peas, beans, and lentils—are a wonderful source of non-animal protein.  Soybeans are high in protein, and contain a healthy type of fat.  Soy is available in many forms— edamame (fresh in the pod), soy nuts (roasted), tofu (bean curd), and soymilk. Fish and poultry are also mainstays of the Mediterranean diet, with limited use of red meats and dairy products.  The benefits of fish in the diet can be fully exploited by eating a good variety of fish.  Olive oil is by far the principal fat in this diet, replacing butter and margarine. The Mediterranean diet avoids processed foods, instead focuses on wholesome products, often produced locally, that are low in saturated fats and high in healthy unsaturated fats. The Mediterranean diet is high in the good fats (monounsaturated and polyunsaturated) which are present in such foods as olive, canola and safflower oils, avocados, nuts, fish, and legumes, and low in the bad fats (saturated fats and trans fats).  The Mediterranean style of eating provides an excellent source of fiber and anti-oxidants.  A moderate consumption of wine is permitted with meals.

Clearly, a healthy diet is an important component of a healthy lifestyle, the maintenance of which can help prevent the onset of many disease processes.  There are many healthy dietary choices, of which the Mediterranean diet is one.  A recent study reported in the International Journal of Impotence Research (Esposito, Ciobola, Giugliano et al) concluded that the Mediterranean diet improved sexual function in those with the Metabolic Syndrome, a cluster of findings including high blood pressure, elevated insulin levels, excessive body fat around the waist and abnormal cholesterol and triglyceride levels.  35 patients with sexual dysfunction were put on a Mediterranean diet and after two years blood test markers of endothelial function and inflammation significantly improved in the intervention group versus the control group. The intervention group had a significant decrease in glucose, insulin, low-density lipoprotein cholesterol (LDL—the “bad” cholesterol), triglycerides, and blood pressure, with a significant increase in high-density lipoprotein cholesterol (HDL—the “good” cholesterol).  14 men in the intervention group had glucose intolerance and 6 had diabetes at baseline, but by two years, the numbers were reduced to 8 and 3, respectively.

Why is the Mediterranean diet so good for our hearts and sexual health?  The Mediterranean diet is high in anti-oxidants—vitamins, minerals and enzymes that act as “scavengers” that can mitigate damage caused by reactive oxygen species.  Reactive oxygen species (also known as free radicals) are the by-products of our metabolism and also occur from oxidative damage from environmental toxins to which we are all exposed.  The oxidative stress theory hypothesizes that, over the course of many years, progressive oxidative damage occurs by the accumulation of the chemicals the accumulation of reactive oxygen species engender diseases, aging and, ultimately, death.  The most common anti-oxidants are Vitamins A, B-6, B-12, C, E, folic acid, lycopene and selenium.  Many plants contain anti-oxidants—they are concentrated in beans, fruits, vegetables, grain products and green tea.  Brightly colored fruits and vegetables are good clues as to the presence of high levels of anti-oxidants—berries, cantaloupe, cherries, grapes, mango, papaya, apricots, plums, pomegranates, tomatoes, pink grapefruit, watermelon, carrots, broccoli, spinach, kale, squash, etc.—are all loaded with anti-oxidants as well as fiber. A Mediterranean diet is also high in omega-3 fatty acids, a type of polyunsaturated fat present in oily fish including salmon, herring, and sardines.  Nuts—particularly walnuts—have high omega-3 fatty acid content.  Research has demonstrated that these “good” fats have numerous salutary effects, including decreasing triglyceride levels, slightly lowering blood pressure, and decreasing the growth rate of fatty plaque deposits in the walls of our arteries (atherosclerosis), thus reducing the risk of cardiovascular disease, stroke, and other medical problems. Mediterranean cooking almost exclusively uses olive oil, a rich source of monounsaturated fat, which can lower total cholesterol and LDL cholesterol while increasing HDL cholesterol. It is also a source of antioxidants including vitamin E.  People from the Mediterranean region generally drink a glass or two of red wine daily with meals. Red wine is a rich source of flavonoid phenols—a type of anti-oxidant—which protects against heart disease by increasing HDL cholesterol and preventing blood clotting, similar to the cardio-protective effect of aspirin.

The incorporation of a healthy and nutritious diet, such as the Mediterranean diet, is a cornerstone for maintaining good health in general, and vascular health, including sexual health, in particular.  The Mediterranean diet—my primary diet and one that I have incorporated quite naturally since it consists of the kinds of foods that I enjoy—is colorful, appealing to the senses, fresh, wholesome, and one that I endorse with great passion. Maintaining a Mediterranean dietary pattern has been correlated with less cardiovascular disease, cancer, and sexual dysfunction.  And it is very easy to follow.  It contains “good stuff”, tasty, filling, and healthy, with a great variety of food and preparation choices—plenty of colorful fresh fruit and vegetables, a variety of fish prepared in a healthy style, not fried or laden with heavy sauces, healthy fats including nuts and olive oil, limited intake of red meat, a delicious glass of red wine.  It’s really very simple and satisfying.  Of course the diet needs to be a part of a healthy lifestyle including exercise and avoidance of harmful and malignant habits including smoking, excessive alcohol, and stress.  So if you want a sexier style of eating, I strongly recommend that you incorporate the Mediterranean diet into your lifestyle.  Intelligent nutritional choices are a key component of physical fitness and physical fitness leads to sexual fitness.

Andrew Siegel, M.D.

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Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health; in press and available in e-book and paperback formats in March 2014.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with

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Beach Body Season

May 11, 2013

Beach Body Season 

Andrew Siegel, M.D.   Blog #106

Michelangelo’s “David” was at one time a mere solid block of marble.  The master artist crafted this magnificent sculpture by knowing exactly what to carve away.  Antoine de Saint-Exupery (author of Le Petit Prince) wrote: “Perfection is not when there is no more to add, but when there is no more to take away.”

We all have “beach bodies” obscured beneath our perhaps winter-weighted physiques.  We may be a bit flabbier and less toned than desirable, but somewhere hidden within is a sinewy, tight, and lean figure. What can we do to bring out this inner beach body—to allow us to feel confident, svelte and shapely—since swimsuit season is right around the corner?

A great body (and more importantly, a healthy body) mandates a lifestyle encompassing a healthy diet and plentiful physical activity—this is a process incorporated into the daily existence of those who respect themselves and are committed to being stewards of their own wellness.  Realistically, this is a lifetime pursuit—major changes are not going to occur in 6 weeks of “cramming” to achieve a respectable appearance at the beach. However, all journeys start with small steps and with diligence, some real and measurable progress towards that beach body can be made even after a few weeks of effort.  Within a month or so of consistent healthy eating and exercise, we should note the pounds peeling off, better muscle tone, and increased energy levels.

Nutrition to Maximize Our Beach Body Appearance

To help sculpt our bodies to reveal the “David” or “Venus de Milo” within, we are going to need healthy fuel to serve as energy and provide the basic building blocks for the reconstructive and regenerative processes that are ongoing in our bodies.  For weight loss, we will need reduced caloric consumption—3500 calories fewer per week will result in a one-pound loss, a very realistic and reasonable goal.  As weight gain is gradual, so should weight loss be.  No fads, no gimmicks, no nonsensical, unbalanced, ridiculous diets—just a sensible reduction in calories and an effort to eat healthy, nutrient-dense, natural and unprocessed foods.

Since portion control is fundamental to the process, a really easy diet is simply to reduce portions to one-half to three-quarters of our normal size helpings.  When it comes to snacking, we should make every effort to eat wholesome fresh vegetables and fruits instead of processed junk that often contain a load of unhealthy fats, salt and carbohydrates. It is important to make smart choices and often our intuition will suffice to guide us.

Lean sources of protein such as egg whites, wild salmon (or any other wild fish that is grilled or broiled), skinless chicken, turkey breast, fat-free yogurt and soy products such as tofu and edamame are healthy and desirable.  We should be judicious with meat and dairy intake because they are rich in saturated fats and high in calories.  Vegetables are a much healthier source of fat—think nuts, avocados and olives.  High fiber foods—vegetables, fruits and legumes including lentils, peas and beans—are very filling and the fiber regulates the rate of carbohydrate absorption. Intake of a variety of brightly colored fruits and veggies will ensure getting ample doses of phyto-nutrients and anti-oxidants.   We need to attempt to minimize the rich sauces and fattening dressings put on otherwise healthy foods…if we cannot avoid them, then we need to use them in moderation.   It is important to be careful with our sodium intake as it causes fluid retention, bloating, weight gain and a number of potential medical issues.

And now a brief discussion of the science of fat: Our hormone insulin has much to do with the way our bodies store or burn fat—when insulin levels are elevated, we accumulate fat; when levels are low, we burn fat as fuel.  Our insulin levels are more-or-less determined by the carbohydrates we eat: the more carbs we eat, the sweeter they are, the easier they are to digest, the greater the insulin levels and the more that fat accumulation is driven. Insulin secretion caused by eating carb-rich foods—flour and cereal grains, starchy vegetables like potatoes, sugars and high-fructose corn syrup—makes us fat.  The sweeter the food, and the easier it is to digest, the fatter it will make us, and liquid carbs such as sodas, fruit juices and beer are probably the biggest culprits.

So, we need to try to steer clear of refined carbohydrates, substituting whole grain products for white bread, refined pasta, white rice, etc.   It is very important to minimize sugar intake since sucrose is fructose/glucose and fructose gets metabolized much differently from glucose, pushing our bodies towards fat deposition…the same thing goes for high fructose corn syrup (HFCS), which should be avoided like the plague.  Let fruits be the source of fructose for our bodies, not refined sugars and HFCS.  It is imperative that we carefully read food labels to know what we are consuming.

To repeat a very important principle: if we want a beach body we do NOT want to drink our calories—actively avoid liquid calories such as soda, juices, processed iced tea, etc.  The best drink is water or seltzer—we can spritz them up with a lemon or lime.  Lots of water will serve to keep us well hydrated, dampen our appetites, and will quell our thirsts, which are sometimes confused for hunger.  Remember that liquid calories include alcohol—a beer belly is the opposite of a beach belly.  It is best to be moderate with alcohol consumption during the beach body training period—reducing alcohol will also help us maintain our discipline, which can easily be thrown by the wayside due to the uninhibiting effects of alcohol.  Sobriety will go a long way towards molding that beach body.

Exercise to Maximize Our Beach Body Appearance

Our bodies are remarkably engineered to adapt to the stresses placed upon them with compensation, adapting to exercise with increased muscle strength and fitness.  The general rule of thumb is to think “athletics” and the “aesthetics” will follow.   The key to exercise is diligence—carving out the time—and variety—strength  (resistance) training, cardiovascular (aerobic) training and core (abdominal and torso) conditioning.  A core synergistic exercise regimen, which is a combination of the aforementioned three types of exercise, provides a great overall workout.

Muscles play a key role in our metabolism: they are extremely metabolically active.  With a sedentary existence and aging, there is a gradual loss of muscle mass and a resultant slowing in our resting metabolic rate.  By building and maintaining our muscle mass with strength training, we will raise our resting metabolic rate and burn more calories.  Additionally, exercise serves to increase the “insulin sensitivity” of muscle, which means that our muscles become more efficient at burning off carbs as fuel, before they have a chance to become stored as fat.

We can measure our maximal heart rates by doing an aerobic activity, such as swimming, running or cycling full throttle until we can’t go on, and then taking our pulses.  In our workouts, if we can achieve a heart rate of 75% of our maximum rate and sustain that for 30-60 minutes daily, it is easily conceivable to burn 600 or more calories per day.   High intensity interval training—alternating between extremely intense exertion and regular “normal” exertion—can rapidly help propel us towards the beach body within.

“Integrational” exercise—incorporating non-gym physical activities into our daily lives—is an alternative form of exercising that burns calories and gets us moving just the same.  These include gardening, house chores, vacuuming, walking the dog, chopping down trees, etc.  It has even been shown that fidgeting will do the trick.  The key is to get off the couch and get moving.

In order to feel and look your best it will take the combined efforts of diet and exercise.  A healthy diet is fundamental and will help you look great in clothes, but it is the exercise component that will help you look and feel great in a bathing suit. Maintaining good posture like a ballet dancer will help with the beach body mode—David and Venus certainly do not slouch forward with rounded shoulders.  To this end, yoga and Pilates are wonderful forms of exercise. Getting enough rest and sleep is also imperative.  Insufficient sleep makes it difficult to exercise and the fatigue eating that often ensues can often be detrimental to our goals.

Minimizing stress and negativity in our lives will help many causes, including the beach body one.  Our stress hormone—cortisol—functions to stimulate our appetites and cravings and promotes fat deposition and weight gain. Stress can be managed in a healthy fashion through exercise as opposed to the unhealthy habit of stress eating.

Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:

Available on Amazon in paperback or Kindle edition

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Untangling Twisted Health Messages

October 12, 2012


I just finished reading a fascinating book published by Beacon Press entitled: The Cure For Everything: Untangling Twisted Messages About Health, Fitness, And Happiness.  It is authored by Timothy Caulfield, a health law and policy researcher who holds appointments at the Faculty of Law and School of Public Health at the University of Alberta, and challenges and invalidates many of the “myths” of health crazes. I wholeheartedly recommend picking up a copy of this very worthwhile read that I found to be educational, engaging, entertaining  and confirmatory of many of my own thoughts and feelings.

The following words are verbatim from pages 185-188 of the book, essentially a summary of his concluding remarks:

The results of my research point to a disheartening conclusion, which is, basically, that nothing works. Despite the immense diet, fitness, and remedy industries, very little actually does what it promises to do. A scan of your genes will not tell you what will happen in your future; for most of us, it’s no more useful than the numbers we get from a scale or blood pressure cuff. It is nearly impossible to transform your body through exercise alone. You cannot get sexy abs instantly or even after weeks of intense work.  There is no such thing as toning, and virtually every fitness gimmick is just that: a gimmick. To lose weight you have to eat fewer calories than you burn. Sadly, we don’t need many calories. There is no shortcut to weight loss.  And even if you can take off the pounds, keeping them off is the real challenge.  The failure rate is so high that some experts I interviewed thought that sustained weight loss is… sigh… impossible.

 Finally, most of the remedies offered by alternative practitioners work no better than a placebo, and the pharmaceutical industry has such a tight grip on the production of the relevant science that is difficult to trust any available information about any drug, when it comes from an advertisement, your physician, or even a respected medical journal.

 In short, there are no magical answers. This should not come as a surprise, of course. If it were easy, we would all be healthy. If alternative therapies worked, we would have verifiable data demonstrating their efficacy.  If losing weight and getting fit could be attained by utilizing a metabolism-enhancing, colon–cleansing yoga move, we would all be slim, cut, and have pristine innards. Alas, this is not the world we live in.

 On the other hand, there’s another way to look at the results of this inquiry. This is the glass half full view. If you want to optimize your health, the steps are, in fact, surprisingly simple. The steps are not easy – real effort is required – but they are straightforward. It isn’t complicated.

 This is a liberating realization. It means you can shut out most of the noise. Ignore the advertisements. Ignore the miracle–cure promises made by alternative practitioners. Ignore any marketing message that includes the word detoxify, cleanse, metabolism, enhance, boost, energized, vitalize, or revitalize.  Ignore the twist! Don’t get fooled by the sexy abs images that are such a huge part of Western culture. Don’t worry about the genetic predispositions that have been handed to you in the biological lottery of life. Unless you have one of the rare single gene disorders, like cystic fibrosis, or one of the relatively uncommon highly predictive mutations, genetic information is simply not that valuable.  Don’t get suckered into buying useless potions and practices that are wrapped inside an ideologically fuzzy and truth–obscuring blanket. It will only empty your wallet. And don’t get too excited when the media reports some big health breakthrough, especially if the story is based on a single study. True breakthroughs are rare.  Think of science as a slow and iterative process. As geneticist Jim Evans told us, science is a slog. Two steps forward, one and a half steps back. 

 What, then, are the straightforward steps to maximum health?  First, exercise often and with intensity (intervals work best) and include some resistance training. Second, eat small portion sizes, no junk food, and make sure 50% of what goes in your mouth are real fruits and vegetables.  Third, try your best to maintain a healthy weight – yes this is insanely tough, but we should at least try. Fourth, do not smoke, and drink only moderate amounts of alcohol. And fifth, take all the well-known and simple injury-prevention measures, such as wearing a seatbelt in the car and a bicycle helmet when you go riding.

Once you cut through the twisted messages that saturate our world, you find out all the available evidence tells us that these five steps are by far the most important elements of a healthy lifestyle. One expert I corresponded with for the diet chapter, Walter Willett from Harvard, figures that healthy food choices, physical activity, and not smoking could prevent over 80% of coronary artery disease, 70% of stroke, and 90% of type II diabetes.

 There are other measures, such as getting a good night’s sleep, that are important, and future research might compel me to add them to the list. And we should be conscious about eating certain other foods in addition to fruits and vegetables, like fish, berries, and whole grains.  Also, there are things that should probably be avoided, such as sodium and trans fats. But, in the big picture, these five actions remain essential. All the other stuff
– such as the alleged importance of various supplements and the craze for organic foods – will likely have only a marginal impact on individual health.  If you’re not doing all the big five, worrying about the details – such as a slightly increased genetic predisposition to some common disease or the cleanliness of your colon– is ridiculous.

There are no magical cures or programs. But the simplicity of the untwisted truth has an almost magical quality.


 Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:

Available on Amazon in paperback or Kindle edition

Blog subscription: A new blog is posted every week.  In the lower right margin you can enter your email address to subscribe to the blog and receive notifications of new posts by email. Please avail yourself of these educational materials and share them with your friends and family.



What Is The Best Diet For Us?

August 6, 2011

What is the best type of diet for us?  There are a lot of zealots and fanatics out there touting the advantages of one diet over another.  What to believe?

Vegetarian? Vegan?  Raw? Flexitarian (mostly vegetarian, but some meat)?  Pescatarian (fish)?   Paleolithic (like our cavemen ancestors)?  Carnivorous (like lions)?  Herbivorous (like deer)?  Granivorous (nuts and seeds) like squirrels?  Frugivorous (fruits) like lemurs?  Foliovorous  (leaves) like koalas?  Omnivorous?

When it comes to eating—like religion—I don’t like other people foisting their views on me.  That stated, when it comes to diet, eating and nutrition, there are some basic facts that are relevant to our health and wellness. In our modern society, if you want to stay on track regarding diet and weight, it is not so much what you choose to eat, but what you elect not to eat that count.  Essentially, by avoiding the “bad,” by default you will be fueling yourself with the “good.”  In other words, there are a great variety of healthy, high quality foods that can nourish us, and it is not important what your specific choices are as long as there is balance, sufficient intake of macro-nutrients (protein, fats and carbs) and micro-nutrients (vitamins and minerals), and avoidance of excessive calories. The key is to stay away from processed, reconstituted, unhealthy, mystery, faux foods. Processed food can be defined as real food that has been altered in order to lower its production cost, lengthen its shelf life, make it look more appealing and make us want to eat more of it, resulting in a reduction of nutritional content and an increase in chemicals, dyes, preservatives and toxins.

Humans are remarkably omnivorous, meaning that there are a great variety of different foods—plants and animal in origin—that can both provide energy for our metabolic processes and sustain us in terms of cellular and tissue replenishment. Regarding what to eat to maintain good health, the celebrated author Michael Pollen famously stated: Eat food, not too much, mostly plants.  I borrow his maxim and reverse it in an effort to summarize what to eat to promote poor health: Eat imitation food, eat a lot of it, mostly animal-based. And there we have the Western diet—processed foods, lots of meats, refined carbs, fats and sugar—the eating style that has contributed to two-thirds of Americans being overweight or obese. The Western diet is largely responsible for the diseases of Western civilization, namely hypertension, diabetes, cardiovascular disease and some cancers.

Processed garbage foods are ubiquitous in the United States of Obesity. These run the gamut from doughnuts to hot dogs to the myriad of chemical-laden, nutritionally-depleted food-like substances that are readily available, aggressively marketed and promoted, relatively inexpensive, and potentially addictive.  Fast foods, junk foods and many packaged foods—cheap, easy, and a staple of many adults and children—are in this category. Much of this is not actually food, but enhanced food-like matter, highly processed and laden with additives, preservatives, and loaded with fat, sugar, salt and other chemicals (most of which are unknown, unpronounceable, unrecognizable, un-food-like concoctions)—engineered in a science lab.  The “killer” triad of processing is enriched wheat flour, high fructose corn syrup and partially hydrogenated vegetable oils.  In contrast to wholesome, slow-digesting, natural foods that contain abundant fiber—which slows and regulates glucose absorption and leaves us feeling full and satisfied—nutritionally-void, packaged foods laden with fat, sugar, and salt promote addiction.  These highly-refined food substances are essentially pre-chewed, pre-digested, melts-in-your-mouth adult baby food that is absorbed very rapidly because of the fiber-stripping and refinement process.

The term processed is a derivative of the word procession. A procession is a movement that occurs in an orderly fashion, for example, a parade. The procession that results in processed food on our plates involves the farmer, the processor, the baker, the distributor, the retailer, and ultimately us, the consumer. For example, wheat is grown and harvested by the farmer and the process of threshing separates the wheat kernels from the chaff (husks of the wheat grains). The process of milling enables the wheat kernel components to be separated such that the bran and germ are removed, leaving the pure, silky, highly refined powder that we know as wheat flour. This wheat flour is then used as one of the many unhealthy components of processed foods, for example—a Twinkie. After the Twinkie is configured, baked, sealed in plastic wrap and boxed, the distributor trucks and ships the product to our local supermarket retailer where it can be purchased. So what starts out as a healthy and natural grain, after much processing, ends up as unhealthy junk food. The final product bears little relationship to the original farmed product. The bottom line is that the more that is done to our food, the more it gets depleted of its nutritional value.

Remember the game called “telephone” we used to play when we were kids? A bunch of us would sit in a circle and the first person would whisper a few sentences into the ear of the person sitting next to him or her. That person would repeat it to the next person, and soon around the circle. The last person would announce the message they heard. The message that the final person announced was virtually always very different and distorted from the original message, usually in a very funny way. My point is that the processing of food is not unlike this game in that the final product bears little, if any, relationship to the original, with each step in the production process resulting in increasing adulteration.

Minimizing one’s exposure to processed foods, as difficult as that might be, is a noble idea in terms of avoiding being overweight or obese and maintaining good health. Examples of processed foods are: Pop Tarts, Hostess Twinkies, Spam, Doritos…the list is virtually endless. Processed foods can be as detrimental to our health as tobacco has been proven to be, contributing to diabetes, obesity, hypertension, cardiovascular disease and cancer.

As much as I am denigrating processed foods, it is important to understand that not all processed foods are bad and that food processing is a necessity. We cannot all be farmers and grow a variety of vegetables and fruits and raise cattle and other livestock and must rely upon intermediaries to transform a raw product such as wheat grain into an edible form. However, the desirable goal is to eat a healthy, nutritious, robust, wholesome processed product, for example, 100% whole grain wheat bread vs. the infamous un-wholesome Twinkie. Obviously, the closer any food item resembles its original and natural form, the healthier it is, but many original forms do need to be processed to some extent to make the food available to us. In general, real food comes from the earth and not the laboratory, and the less processing the better. The corollary of this is that the more processed and highly altered the food is, the less nutritious—and oftentimes more hazardous—it becomes.  Processed foods in addition to being unhealthy and nutritionally void, have an abundance of sugar, salt, fat, additives, preservatives, flavor enhancers, chemicals, and dyes. Some processed foods are filled with mystery components. Often, to make up for loss of nutrients during processing, synthetic vitamins and minerals are added.

I am a pragmatist and am not advocating absolute purism with complete avoidance of processed and junk foods, but am a big supporter of minimizing our intake of them.  I suggest making a concerted effort to eat healthy, wholesome and natural foods as much as possible, but the occasional succumbing to the urge and craving to consume some processed junk food is acceptable…everything in moderation.

Bottom line: In my opinion, the healthiest kind of diet is a non-processed diet.  Any diet that provides sufficient but not excessive calories, is balanced in terms of macro and micronutrients, and is largely non-processed should prove to be a healthy diet. Non-processed will ensure the intake of an abundance of natural and wholesome foods.  The surest way to ruin the health benefits of a vegetarian or a vegan diet—those diets that are touted as quite healthy—is to couple them with the intake of processed foods!  There are way too many vegetarians who are overweight for this reason.  I am an omnivore who espouses avoiding processed foods and encourages a diet that emphasizes vegetables, fruits, legumes, whole grains, and lean animal products in moderation. I believe that if this kind of diet was adhered to, it would contribute positively to curtailing the American obesity epidemic.

Andrew Siegel, M.D.

This is just a taste of what you will find in Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food. The website for the book is:

It provides information on the book, a trailer, excerpts, ordering instructions, as well as links to a wealth of excellent resources on healthy living.  It is also available on Amazon Kindle.

To see my YouTube video on Processed Foods: