What a Cardiologist Eats

“What’s your secret to staying so trim?”

The question came from a patient I had been seeing regularly for over 15 years. The painful truth? Not long before then, I had been more than 20 pounds overweight. Although that’s difficult to admit as preventive cardiologist, it was being overweight that set me on the path to my current diet. And my healthier weight.

Like many of us, becoming overweight snuck up on me. I grew up thin, but around the time I finished residency, things changed. Seemingly overnight, my pants became too tight and the scale was showing numbers I had never seen before.

Although I was surprised by this, I shouldn’t have been. I was older, and I didn’t have the “eat anything and get away with it” metabolism anymore. I knew that to improve my weight – and my health - I had to change what I was eating.

The thing was, like most physicians, I didn’t learn a lot about nutrition in my training (this is surprising, I know – you’d think medical school would cover healthy eating, but not at all). It was clear to me that I needed to become a nutrition expert for myself, but for my patients as well.

I began my quest to find the “best” diet in the same way I would answer any clinical question. I reviewed the highest quality research, read the most relevant books, listened to lectures, and talked to the leading experts. However, this didn’t work as well as I had hoped. In fact, the more I read, the more confused I was. Experts with very different beliefs convincingly shared their stories with evangelical zeal on why their diet was best. Very different diets, ones that appeared to be polar opposites, like vegan and Paleo, had seemingly convincing research “proving” their diet was best. 

I struggled to reconcile all of this conflicting data – until I realized two truths.

The first truth was that all of the evidence-based diets are “best” for some people. But none of them are the best diet for everyone.

The second truth was that all of these healthy diets had one thing in common: They eliminate highly processed food.

Whether you believe the best diet is paleo, vegan, Mediterranean, whole food plant based, or any of the other evidence supported diets, the one thing that they all have in common is that they recommend eliminating highly processed foods.

Although this may seem overly simple to some, the reality is that almost 60% of the average American diet is highly processed foods. And while our current epidemics of obesity, diabetes, high blood pressure, and other lifestyle related diseases have many potential causes, the wide availability of highly processed foods starting in the 1970s is likely a major contributor.

Fifteen years ago, I decided that the foundation of my diet would be to avoid or minimize highly processed foods, which I define as food high in added sugars or refined grains. Typically, highly processed foods are manufactured with lots of ingredients, chemicals, and preservatives that don’t qualify as food.

My diet is mostly real food and that includes several things that some would not consider “heart healthy,” such as whole fat dairy and eggs. I also eat red meat once or twice a week, although I choose higher quality and naturally raised options when possible. I still like my carbs, but have made the switch to brown rice and whole grain pasta and I have also upgraded my snacks. Instead of packaged foods, my snacks are most often home-made popcorn, nuts, dates and nutrition bars with only whole food ingredients. And I don’t completely avoid high sugar foods. I’m just more selective. For me, my mom’s homemade chocolate cake is worth the splurge. A candy bar or store bought pastry doesn’t even come close – so I turn those down. I don’t deprive myself, but a strategy that works for me is to ask, “What’s the least I can eat and still feel satisfied?” Often it’s just a bite or two.

The last aspect of my diet I want to mention is the amount of food I eat. Eating too much good quality food is still too much. I struggled with how to eat the right amount of food, until I adapted a mindful eating strategy. Paying attention to the food I’m eating, taking my time, and not always cleaning my plate were effective strategies for me to eat enough without over eating.

This is my “best” diet, but it’s not a finished project. Even 15 years later, I’m continuously trying new foods and ways of preparing them (I love my new air fryer!), and I suspect that will never change.

More importantly, what is the best diet for you? I can’t answer that question for you, but here are 3 steps that might help: 

1. Minimize or eliminate highly processed foods, processed meats, and deep fried foods. While making small changes over time is often an effective strategy to lasting results, completely eliminating all processed foods for a period of time (a week to a month) can help reset your taste buds and get you on track faster.

2. You have to like what you’re eating. If you don’t enjoy what you’re eating, or feel deprived, it’s not likely sustainable. Don’t be afraid to experiment to find foods that you enjoy AND that are good for your health.

3. Practice mindful eating. Don’t be put off by the term. Simply pay attention while you eat, savor each bite, and stop when you’re nearly full.