Springfield, Mo. — You are what you eat. You’ve probably heard that before.
So, what does that make most of us average, everyday eaters?
“Sick,” says Dr. Karissa Merritt, a physician training for family medicine at CoxHealth. “A large percentage of our chronic disease burden is lifestyle-related,” Dr. Merritt said. “That’s either what we’re eating, or not eating, how much we’re moving, or not moving.”
Food shapes culture all around the world and the United States is no different from Thanksgiving, Christmas and Super Bowl to barbecues, birthdays and weddings. The list of social eating opportunities spans the entire 12-moth calendar.
If food is culture and if it’s part of our identity as a society, why (and how) would we change our habits? Your health is the reason why. It turns out it takes more than an apple a day to keep the doctor away. You have to keep the apple pie away, too.
Ask the doctor: meat consumption
While some people might choose to follow a vegetarian or vegan diet for ethical reasons, others might choose that lifestyle based on the health benefits of it. Dr. Merritt says the data surrounding meat consumption varies. Still, most suggest that excessive meat consumption harms health.
“Less meat is probably better,” she said. “We are starting to see some research that supports plant-based diets having an impact on life-span and also the quality of life.”
Why we should change the way we eat
Our ancestors used food for survival. Today, we use food for pleasure, and too much of it, according to Shannon Crosby, a corporate wellness dietitian at CoxHealth.
“If I think about what Americans are eating right now, we just are eating too much,” she said. “We make choices based on how food tastes and the food that tastes the best is high in sugar, high in unhealthy fats, and processed.”
All of that causes inflammation in the body. Crosby says much like when you have cut on your skin your body will react to heal that and fight any type of infection that might occur, the same happens inside your body when you eat certain foods,
“We think that this chronic inflammation is kind of the root of the diseases that impact Americans today,” she said. “Chronic diseases like heart disease, diabetes, and certain types of cancer, we think maybe go back to that chronic inflammation,” said Crosby.
But while food is the problem, it can also be the solution.
“Food is the only medicine that we are all taking every day,” Merritt said.
Ask the doctor: ketogenic diet
Simply put, a ketogenic diet is a very low-carb diet that helps many people with weight loss. Crosby explains that typically body cells burn carbs for energy, but they also burn fat. So, when you deprive your body of carbohydrates, your cells will shift and get more energy from fat. That’s going into ketosis, which also curbs your appetite.
Shannon says studies showed that people on a keto diet lost weight faster than other diets; however, that gap was smaller or non-existent long-term.
“We don’t have many studies on the long-term health effects of it, and part of that is because it’s hard for people to stick with long-term. So, when they do long term studies, people tend to drop out,” Shannon said.
How can we change the way we eat
There are many different types of diets out there; it can be overwhelming.
First, if the goal is to lose weight, a calorie deficit is the first step, according to the experts. But the best way to do that will depend on each person, and there are several things to consider.
“Are they getting enough carbs, proteins, fats, and all those important nutrients we need to sustain life and be healthy?” Crosby said. “If it’s vegan and checks those boxes, then I’m ok with
it. If it’s keto and checks those boxes, and you can be consistent with it, then I’ll probably be ok with it.”
Dr. Merritt says she keeps it simple with her patients.
“Eat when you’re hungry. Don’t when you are not. And eat real food,” Merritt says. “Eat things that exist in the grocery store the same way they existed in the world. So, eat the apple, not the apple sauce, eat the potatoes, not the mashed potatoes, the rice, not the rice cake.”
Ask the doctor: should you eat fruits if you’re trying to avoid sugar and carbs?
The short answer is: yes.
Crosby says that although fruits have sugar, they also have a lot of fiber, which slows down how quickly you digest it. In contrast, sweets like a donut or a can of soda, for example, will be primarily sugar, if not all.
“If you take an orange that has 15g of carbohydrates of almost all sugar, that’s a big difference than a handful of candy that’s 60-70 grams of carbs,” she said.
And fiber is what we need; Americans are not eating enough fiber. On average, Americans are eating about 15 grams of fiber, when most people need about 25-30g.
However, someone who is on a keto or low-carb diet might opt for blueberries rather than a banana, for example. This swap would keep those carbs low but still get the benefits from fruit.
Where do you find fiber? Fruits, vegetables, nuts, seeds, whole grains, and legumes.
They say there’s no one best diet for everyone other than a whole foods based-diet that meets all of your nutritional needs.
“There are special circumstances; people with thyroid issues, pre-existing diabetes, hypertension, women with the polycystic ovarian disease. Those diets are going to look a little bit different. And so, it’s important to speak with their doctors about really what that should luke. No diet is one-size-fits-all.”
Dr. Merritt says food is medicine and the first step to helping people heal. So she began prescribing “healthy food” to her patients. Merritt and other doctors in the CoxHealth system are prescribing healthy food and working with Crosslines in Springfield and Community Gardens, where patients can go “shopping.”
She says this allows people who otherwise wouldn’t be able to afford fruits and vegetables, fresh meat, and protein-rich grains access to those items.
Ask the doctor: intermittent fasting and calorie restriction
Intermittent fasting restricts the window in which you are consuming calories, and as a result, restricts your calories. For example, some people might choose to eat for eight hours a day, and refrain from eating for the next 16 hours, which includes sleeping hours.
“Over 20-30 years of data show calorie restriction has proven to expand life-span, and that excess calorie consumption is linked to early death,” Dr. Merritt said.
She says some special patient populations might benefit more from this strategy than others, for example, endurance athletes.
“It has to do with the way their body reacts to the sugars during that time when they eat and don’t eat,” she said.
“Where we see people struggle with it is often women,” Dr. Merritt said. “There are some hormonal components that make it more difficult to benefit from an intermittent fasting diet.”
“In Springfield and Greene County, we see that we have poverty at almost twice the level of the national average. And about 25 percent of our Greene County neighbors rely on convenience store food as their primary source of grocery shopping, which is extremely concerning,” she said. “And it would be crazy to think that those people would be as healthy as someone who is shopping at the farmers market every weekend.”
The way we eat, as a nation, is economical, and it’s also cultural. Dr. Merritt is one person in her community, doing her part to fight one of those battles and increase access to healthier foods. But the other part of the problem is just as important.
“We have to combat the American culture, that is: ‘things should be easy for me, things should be cheap for me, and they should be quickly accessible for me.’ And that has impacted the way we think about food, where it comes from, how we cook, and how it tastes. And we are feeling that. It’s affecting people’s lives; it’s affecting people’s health care.”
So, if we got ourselves here, we can also get our selves out. But there is no magic pill to fix it immediately.
“What’s important is that you have something sustainable for you, something that changes the way you live your life not just for the next three months but for the rest of it,” Merrit said.