A generation of Americans is still trying to recover from the diet wars. Years of obsessing about fat, calories and carbs has left everyone, well … fatter.
But now, nutritionists and health researchers are seeing signs of change. The percentage of people who are on traditional diets appears to be falling, and there are growing signs of a “positive eating” trend. Positive eaters shun traditional diets and instead focus on eating well, adding foods like vegetables, nuts, berries and healthful fats onto the plate.
In today’s Dining In section of The Times, I explore the positive eating trend and talk to people like Rina Gonzalez-Echandi, a Well blog reader who opted for positive eating after reading Michael Pollan’s “In Defense of Food,” which highlights our unhealthy dependence on processed foods instead of “real” food. “You forget how wonderful it is to have a meal with friends and family,” Ms. Gonzalez-Echandi said.
To learn more about positive eating, read the full story here. And please, share your thoughts and experiences below.
Healthy living doesn't happen at the doctor's office. The road to better health is paved with the small decisions we make every day. It's about the choices we make when we buy groceries, drive our cars and hang out with our kids. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. You can reach Ms. Parker-Pope at 
The easiest and most pleasurable way to eat well is to cook. Recipes for Health offers recipes with an eye towards empowering you to cook healthy meals every day. 
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Health insurance companies must consider regular nutritionist consultation as the most effective preventive measure.
— Shirley R. Lamdan, CLUExcellent article, as usual, Tara.
People should think of lifelong changes in their diet, ie healthy eating. As you know recent studies of the mediterranean diet have shown positive health benefits.
The key is to get rid of the bad eating, junk food habits and add the fruits, vegetables, nuts, good oils. Add a little regular exercise, no smoking, and you are on your way to a healthy lifestyle.
— James Hubbard, M.D., M.P.H.I read “In Defense of Food” and it made so much sense to me. I took it to heart and stopped eating processed food and cut out soda entirely. Without trying, I dropped 5 pounds in a month– and the diet change wasn’t all that drastic, since I didn’t eat much of the processed stuff to begin with.
I feel better, enjoy food more, and wonder how I didn’t see it for myself years ago. I’m almost shocked that my coworkers/friends still drink sodas, eat at mcdonalds, etc. Knowing how much better I feel, I don’t really miss what I used to eat. I think this philosophy could really help a lot of people. Instead of the cycle of deny-binge-deny-binge, daily moderate consumption of yummy food is so much more satisfying.
— D.C.D.I use this philosophy and have been able to shed about 15 lbs. (I’m working on another 10) This was more or less the philosophy behind “French Women Don’t Get Fat” and a book by another NYTimes dining contributor “The Skinny: How to Fit in to Your Little Black Dress for Forever” by Melissa Clark. The secret behind all of this? Enjoy what you eat, and if you eat what you crave, you won’t want as much of it. It’s simple and sounds indulgent, but it works. I’m happy, I don’t feel deprived and I don’t feel like I’m setting myself up for a big crash any time soon.
— CarolynDon’t forget that the better eating that yields weight control is due to less calorie intake. Adding fruits and veggies to one’s already high calorie diet is ineffective in weight reduction (read Jane Brody), though it may have other health benefits.
While being fit and fat is better than just being fat, obesity by itself is an independent risk factor for chronic disease.
FROM TPP — I think for some people adding vegetables and more low-energy density foods (meaning they have fewer calories by weight) does lead to weight loss. That was shown in the vegetable study cited in the article and Barbara Rolls at Penn has also found this in her “volumetrics work.” If you think about it, it makes sense. I could eat 8 ounces of fried chicken and feel full. Or I could eat 8 ounces of grilled chicken and a heap of vegetables and feel full. But in the second case, even though I’ve eaten more food, I’ve consumed far fewer calories.
— jackThanks TPP. This is important. It seemed for a while that we lost sight of the idea that food is good for you. Sometimes I wonder if what’s really bad for you is anxiety about food. Do you happen to know if anyone has done studies on whether attitudes toward food have an effect on weight as such? It’s probably difficult to separate out cause and effect there. I’d guess that people with healthy attitudes about food choose a healthy diet.
FROM TPP — It’s an interesting question. Obviously food issues and anxieties lead to eating disorders, and we know emotional triggers can lead to eating binges. But I haven’t seen data on the broad issue of viewing food as the enemy — although we know dieters tend to think that way and we also know people who regularly restrict their diets end up going on eating binges and regaining weight etc. You’re right that it’s all tied together.
— AnnieEating better is definitely the key. Not to say of course that you can gorge yourself on endless amounts of healhty food and still expect to be healthy and/or thin. I’m a former fast-foodie. I had a number of health problems in my mid 20s. but being fat was NEVER one of them. I was alway on the thin side. Anyhow, changing my diet to all natural, whole, fresh food (which I cook myself from scratch) changed my life/health. For a few years I was vegan (not super hard core but predominantly). But after a while though, I just never seemed to feel full. Even after incorporating some poultry/meat into my diet. I was eating plenty of fat from vegetable sources (like avocados, nuts, seeds) but something in me was craving animal fat. I started eating cream and yogurt (from sustainably raised cows) and — hallelujah — I started to feel satiated again. And no I haven’t gotten fat. But I am getting to the age now where I’m not as naturally lean as I used to be without excercising. Modern nutrition focuses too much on quantity (low-calorie, low-sugar, low-fat). More emphasis should be on QUALITY.
— IdealistAfter reading Gary Taubes’ book Good Calories, Bad Calories and The Omnivore’s Dilemma + In Defense of Food, I became unable to eat white carbs (sugar, white flour, white rice, etc.). In order to cut these out, I essentially went on a low-carb/Atkins-like diet and lost 30 lbs over about 5 months. I’ve easily maintained that weight for another 6 months and feel healthier than I have in years (strong, healthy skin and hair, consistent energy, better sleep). Very sweet or floury things no longer appeal to me, while the flavors of more interesting foods have gotten more intense and enjoyable.
My food, when I look at it on a plate (lots of veggies, protein, nuts, whole grains, fresh fruits, cheese) looks very healthy. People comment on it as being very healthy. When I enter it into nutrition calculators or compare it to nutritional recommendations from the government, it looks very unhealthy. This discrepancy is alarming and seems to suggest that the current way of breaking food into nutritional numbers doesn’t make sense. A study of nutrition from the perspective of an individual’s whole diet — an analysis of food, not numbers, seems like it would be useful.
— ErinI agree with the comment that it’s an excellent article. One major point still needs to be addressed (and I believe you wrote an article about this Tara) in that you get more junk food per dollar than healthy food. If that ratio was flipped and it cost more to buy a box of Twinkies or chips than fruits and vegetables, that would help address the root of the some of the major health care issues we have today. Every two weeks for my family of 4, which includes a 9 year-old and a 5 year-old we spend around $300 to $400 in groceries and that is after drastically cutting down the amount of junk that we buy due to my wife and I reading about what’s good, nutritional food for us and more importantly our children.
I’m not saying it would solve all of the health care problems this country is facing, but if you could buy healthy, nutritious food for a cheaper price than the junk that lines the aisles, we’d tilt the wheel in our favor.
Thanks,
Jeff
FROM TPP — The post you are referring to is A High Price for Healthy Food. It was controversial as many readers don’t believe it’s cheaper to eat junk than quality food. I’m with you though — healthful foods, particularly quality produce, are not cheap.
— JeffYou can definitely eat a lot of a healthy food like brown rice and consume fewer calories than if you ate an equivalent amount of ice cream. But I think that it’s important not to throw out the concept of eating less altogether - just don’t do it in a crazed, self-depriving starvation way. The key is reasonable portion size. My husband and I have switched to smaller plates and salad forks, and that helps. Also, eating slowly is important. So a combination of healthy food, reasonable portions, and slow-eating (plus some moderate exercise) is what works best for us.
— NancyChanging your eating to lose weight is a simple, painless, three-step process. The above article outlines the first step. Here are all three steps:
One, add good food to your usual McGargle’s regimen, as described in the article.
Two, subtract bad food (which is sugar and flour first, then rice and corn and the other grains and potatoes and yadda. Ignore fat except for transfat, which you must of course eschew since it tastes foul. Eschew everything that tastes foul, which would include all processed diet food).
Three, reduce portion size (and extend the nightly fast on both ends–eat dinner early and breakfast late).
If you do these in order and gradually, it is ASTRONOMICALLY easier. Normal people would do it at a leisurely, forgiving pace and thus lose weight in a safe and sane manner. To discover what it’s like to be an abnormal person and do it all in a giant headlong rush not to mention other completely unsafe and insane things, all in an effort to win a weightloss contest, you can go to an amusing blog at visitnomnomnom.blogspot.com.
(There you will find many amusing comments by Rob from South Carolina, if you have been missing him/her here on the Well blog where he/she NEVER SHOWS UP ANYMORE for SOME REASon.)
— Nom, nom, nom!Tara
Thanks for adding the link as I hope people will either re-read it and enjoy reading it the first time. I’m astounded that it was controversial in the fact that some people didn’t believe that junk food is cheaper. Take a calculator to the store and add up say 10 jun food items vs. 10 healthy items (fruits and vegetables) and there’s no doubt that the cost would be twice as much if not more.
This all goes back to the subsidies in the Food Bill that Michael Pollan has addressed in a few informative articles. People need to know this type of information so they can do something about it even if it’s simply writing a letter to their state rep.
— JeffThis is exactly what I have been doing, although I have not increased my physical activity level enough yet. I was truly inspired my Michael Pollan’s book, and looked through several diet books before deciding that Walter Willett and Mollie Katzen’s Eat, Drink, and Weigh Less best put Pollan’s principles into practice. I’ve also been using Judith Beck’s The Beck Diet Solution: Train Your Brain to Think Like a Thin Person. It’s cognitive therapy in book form, to help change habits and habits of mind.
I wish I could report that I’ve shed pounds, but it’s been a stressful time with work and family, and changing habits, especially eating and exercising habits, is very hard. But my husband and I are making a concerted effort to eat more whole grains (switching to whole grain pasta turned out to be a very tasty choice!), more vegetables (thanks to the Well blog, we purchased a copy of Deborah Madison’s Vegetarian Cooking for Everyone), and more cokking with olive oil and less with butter.
I’ve decided the next step for me is keeping a food diary, and meeting regularly with a nutritionist. And my health insurance will cover some of the cost of meeting with the nutritionist.
Thanks, TPP, for the articles and the blog. I’ve found them both informative and supportive.
— Pat McDermott#5 to TPP: You’re correct. Adding fruits and vegetables to the diet may result in weight loss, but this is due to a (HOPEFULLY) reduction in overall calorie intake, not to increased calorie burning.
I’ve seen too many folks choke down an apple before dinner, hoping for some magic calorie burn, and then go back for thier usual seconds on the fried chicken.
— jackI’ve found that eating better food, by which I simply mean nothing processed, using ingredients that are as fresh as possible, leads to weight loss simply because the resulting meal is naturally more flavorful, even without heavy seasoning. It doesn’t matter at that point whether you fried, grilled, sauteed or baked the food, ate red meats and plenty of cream and cheese, etc. because you’ll be automatically sated and satisfied with less regardless.
You eat less, you lose weight. Simple as that.
In contrast, if you eat heavily processed food-like products (canned soups, anything “instant,” that kind of thing), you can stuff yourself till your stomach cries in pain, but somehow, you still crave something.
— KentFor the past 6 years, I’ve been eating a vegan diet mostly based on whole foods and only very occassionnaly processed foods and I’ve been the healthiest I’ve ever been. I do most my shopping at our weekly farmer’s market and get my non-produce items at our local organic market. I get inspiration in the kitchen from classic vegan cookbooks like Vegan Planet by Robin Robertson and The Vegan Post Punk Kitchen by Terro Hope Romero and Isa Muskowitz (who the Times profiled a year ago in a great piece about vegan desserts). I snack mostly on fresh fruit from the farmer’s market. Though my main reasons for eating vegan are related to animal cruelty and the environment, the health benefits are amazing.
— AndreaGreat article, TPP. One angle not addressed, though, is the fact that so many Americans - especially American women - are either restrictive eaters (”dieters”) or in recovery from restrictive eating.
Lifetimes of labeling foods as good/bad, healthy/unhealthy and focusing on the calorie content, rather than what our belly is telling us it wants to eat, leaves people terribly disconnected from their own hunger/satiety cues. Years of deprivation (that food is “bad” so I don’t let myself near it) leads to emotional attachments that take conscious work to un-make.
Articles like this one are a joy to read because you get to see people re-learn that they can enjoy foods and trust their body.
There are some great books, blogs and websites that help people re-learn intuitive eating and the Health At Every Size paradigm is also very helpful in teaching us to listen to and respect what our “guts” are telling us.
— LisaI say can’t one do both?
I eat smaller meals- I use only a bowl to eat out of, it’s about 1 cup 1/2 Maybe , everything I eat is thrown into that bowl, if there’s more food than the bowl can handle that’s for another meal. -
I use fresh whole foods that I can really taste ( processed foods just kill the tastebuds) and try to shop every few days for fresh veggies and fruits instead of stocking up on prefab food., I ride my bicycle to the store (4 miles away) and back home with my stuff in a backpack, so I get exercise too.
I say one can do both. I cut things out of my diet that made me fat and made me feel ill, is it deprevation? Nope because I feel fantastic! I simple adjusted my lifestyle to eating to enjoy with tastebuds that have come alive, I just switched my priorities on what my body and brain felt was good for it, rather than the garbage I thought tasted good but made me feel physically awful-sick and clogged up.
You may feel depraved by not eating a cupcake, but I don’t.
And yes, I agree healthy food is expensive, my food bill is probably double than if I bought the processed food like Mac and Cheese in a box or lunch meat. But I’d rather do it this way and pay for quality over quanity. But one thing I do is wlook out for for “manager specials” at my local shops, you can pick up veggies-I do this with expensive mushrooms, and the likes- that are still in great shape, but they need to move more in, so the veggies are marked down, you eat them that day or the next and it’s still good. It is possible to bargin bin-if you will some of the season available fruits and veggies. Mondays, Wednesdays and Saturdays as early as possible helps you pick up the bargins and still eat right.
— LOlivierI choose both! Eat Less eat better! Guess what? More expensive quality food- say lean local grass fed beef- is cheaper when you buy less! It’s a simple matter of subtraction and everyone wins.
Take the same amount you pay for the cheaper/fattier item and buy that much of the quality food and see what happens.
You pay less at the register, you pay less in tax dollars for the environmental clean up of factory farming, you support rural economies, you weigh less because you are not eating an excess, and you save money countless other ways that investing in a reasonable healthy diet saves you money- by preventing the costs associated with eating poorly. (supplements, skin care products, hair products, antacids, diet foods, exercise equipment, health care, the list goes on!)
I think its easy to see that the real solutions to maintaining health usual fall to the solutions that don’t make any companies large amounts of money. (Lipitor is the number one selling drug in the world yet heart disease rates are the same, processed diet foods never work but cost a fortune, processed low-fat products are an extra marketing ploy but don’t contribute to your health any better than eating less whole fats.)
See here how far a mere 1/4 lb of grass fed ground beef goes in a sauce for two (that also lasts for two more lunches)
— Living Mind to MouthI truly hope that there is a real trend in America towards eating ‘real food’ as M. Pollan suggests as opposed to the ‘low fat’, ‘low cal’, ‘no carb’ crazes that have been popping up all over supermarkets. I think it will make us all healthier. It also will help provide a better eating environment for our children.
Eating less v. Eating better? I think eating better is key, and eating less depends on perspective.
I believe that people need to stop looking at the calories and start looking at ingredients. By looking at ingredients, people can make choices to eat ‘better’ food by eating ACTUAL food. As M. Pollan suggests - eat what your Grandmother would recognize as food.
Eating less does not equate to eating less calories. Eat until you feel satisfied. Don’t feel the need to clear your plate, and don’t be scared to snack when you are hungry. I think you will find that if you start eating ‘real food’ that the cravings you got when you eat a bag of chips and don’t want to stop until its finished go away. You just eat your almonds or yogurt or even home baked cookie and you feel nice and satisfied and don’t need more. I think the worst thing someone can do is decide not to eat say some yummy healthy granola b/c they’d rather have the ‘lower calorie’ cereal that when you look at the ingredients contains stuff you’ve never even heard of. Same with desserts - have the real chocolate chip cookie with sugar and all instead of the chemically filled low-fat oreo or 100 calorie snack pack.
I’ve lived by these mantra for over a year now (i’ve become what I call an 85% vegetarian but 100% ‘real food’ eater), I’ve been more energetic, healthier, happier…..and I can’t complain that I’ve dropped from a size 10 to a size 6. And I don’t cut out the home made cookies or my big vice- wine drinking.
— AmandaHealthy food isn’t more expensive because when you eat healthy food, you eat a lot less food.
Remember when you were in scouts and you learned to build a campfire? You started with kindling and moved on to larger and larger sticks and finally logs? You have to think about food the same way.
If you begin the day with a crisp’n'crunchy bowl of Kashi sticks’n’seeds sweetened with evaporated cane syrup or barley malt effluent or whateveritis they put on that stuff, you’ve eaten a big ol’ load of kindling, which you will burn through in about fifteen minutes. By the time you get to work you’re starving, so you eat a breakroom donut. That’s like throwing a Coleman lantern on the embers of your little campfire. You incinerate the donut in seconds, and now you’re STARVING, so at lunch you eat a hoagie, which is mostly bread, and the cycle begins anew. And so it goes throughout the day until your whole-wheat pasta blowout in the evening and your reduced calorie froyo bedtime snack–you eat kindling all day and never get the big logs on the fire. So you eat and eat and eat, the fire blazes up and then dies down, and you end up spending way more than if you’d just started the day with a nice three-free-range-egg omelet with farmers’ market vegetables in it and a hunk of cheese from the expensive cheese shop and continued in the same vein. (Not to mention that if you can possibly stop eating Kashi for long enough to cure your addiction to Kashi, you’ll never want to eat another mouthful of Kashi again as long as you live. Cereal. Feh. What a pointless excuse for a foodstuff.)
— Nom, nom, nom!I absolutely agree. We only have one go around in this life - why spend all of your time depriving yourself of things that you love?
I think the problem is that the average American has grown so used to Big Gulps and Super Sizes that they have no idea what an actual portion of a meal should be - we can’t just have a slice of cake, we have to eat a gigantic hunk.
I’ve lost forty pounds over the past two years, and found that being aware of what I’m eating is the key to my success (well, that and being a gym rat.) I’m mindful of what I eat and careful in my choices, but also take pleasure and throwing caution to the wind so that I can dig in to a treat now and again. I mean, if you can’t splurge with a hunk of birthday cake once a year, why bother living?
— MegI’m copying my post from the Rachel Ray discussion, b/c it is pretty much my response to this as well, and why reinvent the wheel. I do want to add this to my original statement though - lots of place don’t have farmer’s markets, so that isn’t a viable option for most people. The fact that markets are starting to pop up more and more is a good sign, but it’s still not as simple as just go buy inexpensive healthy food at the market.
In some cases the sticker prices of healthy foods is more expensive than processed foods, in others it isn’t. But the healthy is more expensive than unhealthy argument is deeper than just sticker price. In many communities, particularly inner city urban and very rural areas, stores that sell healthy foods simply don’t exist. If the convenience store does sell fresh produce the selection is usually very limited and the mark up is very high. Add in the time it takes to travel to a store with a decent selection of reasonably priced goods and the time it takes to prepare said food (assuming the person knows how to prepare it) and the cost has sky rocketed.
I don’t want to be all doom and gloom about it, but we have to recognize that there are many factors at play in the way Americans eat. One factor is that lots of people between the ages of 18 and 35 (and older) just don’t know how to cook. Despite all the potential conflicts of interest, the work that Rachel Ray does on TV, in her books, and with Yum-Oh is at least doing something to fix that part of the problem. Another factor is simple access to food. It’s easy to get bogged down in our own day-to-day experiences where grocery stores are abundant, but there are still a lot of areas that just don’t have access to high quality fresh food. There are programs out there to reverse the problem, like urban gardens and economic incentives for companies to open stores in areas that need them, but there’s still a long way to go.
— MPIn response to Jeff:
— ThomasI come from a relatively poor family. My mother always used to say that we are too poor to buy low quality things. She usually meant things like furniture or a washing machine. But, I believe, it is true for food, too.
Given the effect on hunger, a box of twinkies is more expensive than two apples, even organic ones. Twinkies make your blood sugar spike, your insuline levels spike, and, once the sugar is gone, your insuline levels are still too high. You are hungry again. Try that with an apple, won’t work this way.
I don’t think that quality food only comes in form of organic food. For many people it would probably already be a big step forward (and cost less), if they would start to buy unprocessed food, and do the cooking, etc., themselves. And while you are at it, try to enjoy that processing.
This brings me to another topic I have written about here a few times: About 2 years ago I “invented” the term benevore. That was in response to all the other “vores” out there, the carnivores, the omnivores (and their dilemata), the vegans, the organoves. The benevore will simply eat what he/she feels is good. He/she will enjoy the preparation of the food, the food itself, and the act of eating. It appears as if the article here wants to say exactly this. While you are cooking, enjoy the colors, the scents, the texture, the changes in all of them. While you are eating, enjoy your food, your company, your glass of wine (or beer or milk, but enjoy it). Take your time eating. TV can wait (TiVO will do the waiting for you). Throw out your TV, and if you must, perhaps some other obligations. Life is too short to eat badly.
I don’t have a success story with this. I have not lost weight that I am aware of, but I don’t think that anyone in my family is over or under weight, and, with a few exceptions, no-one among our friends with whom we enjoy food is.
I bought the Beck book after reading about it here (some opera singer used it successfully–not Deborah Voigt), and I was disappointed at how much it enforces the restrictive eating/ diet mentality. It is about how to stick to your DIET==set up for a binge for me. I have modified some of the principles for a non-restricted healthier “strategy,” for want of a better word,–based on Michael Pollan’s In Defense of Food (I lost 35 lbs on a similar concept a few years back, and only regained a few), but Dr. Beck is quite rigid about not varying from her precepts which demand a DIET plan, which introduces a huge amount of cognitive conflict for a “good girl.” I applaud TPP’s efforts together with the constructive Well bloggers to sort through the morass of conflicting data and advice about how to lose weight. We can figure this out together!
— Kathryn