Embrace the Bitter

Do you like the taste of black coffee? How about Brussels sprouts? Or dark chocolate? While these bitter foods and drinks can be a challenge to enjoy, research consistently points to these compounds as some of the most beneficial to our health. The taste of bitter is complex and a bit of a catch-all, as there are thousands of bitter compounds in nature; some of which have specific genes identified with their taste perception. So you may like some, but find others overpowering. However, abandoning bitter will cut you off from some of the healthiest foods in nature.

Why are bitter flavors unpleasant and yet healthy?

Compounds in fruits and vegetables protective of health are part of the plants defense mechanisms- its immune function. By consuming them, we incorporate these chemicals into our immune systems as anti-oxidants, anti-tumor factors, and anti-inflammatories. These compounds protect plants from insects by either being unappealing or even toxic. Not surprisingly, we interpret bitter flavors as potentially dangerous, a sign that we may be consuming a poison. Additionally, strong bitter flavors don’t always appeal to modern pallets used to sweet tastes.

And yet, the very compounds associated wth danger in the short term, are highly protective of health in the long term. Perhaps to help us navigate this seeming contradiction between life and death, humans developed nearly ten times as many taste buds for bitter flavors as sweet ones. As a result, the taste of bitter is more complex and nuanced than sweet.

Bitter flavors are also digestive stimulants. Bitter drinks are traditionally used both before and after meals, promoting digestion in two ways:

  • activating digestive “taste” receptors which release enzymes and acids to help us break down our food
  • stimulating digestive muscles to keep food moving through our system

How you can embrace the bitter

  • Train your taste buds. Our taste buds are adaptive, we can learn to enjoy new foods and flavors over time. Most people don’t like their first sip of coffee and find vegetables less appealing as children, but come to enjoy both over time.  Part of this adaptation is age driven, children have many more taste buds that are more sensitive than adults.
  • Try using bitter flavors in foods to remind you to tune into the experience of eating. These strong tastes can help us pay attention to our food and appreciate the health benefits that we are providing our bodies by consuming them.
  • Most phytochemicals don’t degrade in heat or acid, while the flavors are softened by both. So cook your bitter greens and finish them off with a squeeze of lemon. If you are a fan of bitter flavors, eat some raw bitter foods and know that you are maximizing the health benefits.
  • Challenge yourself to include a bitter food in your daily meal plan every day for 30 days. Currently bitter foods comprise only 5% of our daily intake.
  • Check out this prior post on cooking greens or Jennifer McLagan’s cooking blog and cookbook for inspiration.

Some bitter plant foods to keep you healthy

  • Cruciferous family: cabbage, Brussels sprouts, broccoli. These contain high levels of sulforaphane which may account for the anti-cancer benefits of regular consumption of this group of vegetables. Several studies report a 30-50% decreased risk of prostate, colon, pancreatic, and breast cancer associated with eating 3-7 servings per week.
  • Leaves: kale, beet greens, arugula, collards. Luetin is a phytochemical that may promote healthy vision and skin while protecting against chromosome damage.
  • Roots: turnips, rutabagas, radishes.
  • Citrus: grapefruit, lemon peel.
  • Cacao, green tea, and moderate amounts of coffee: bursting with phytochemicals and anti-oxidants, these foods help protect cells from damage, improve blood flow, and reduce inflammation.

What to know more about these mysterious health promoting compounds and how we relate to them in our food? One of my favorite podcasts about food, Gastropod has an entertaining episode all about bitter.

Happy eating,




Fruit is Super Food

As a nation, we don’t eat enough fruit- less than 1/3 of US adults consume at least 2 cups per day. What? Given our desire for sweet flavors and convenient, ready to eat food, you might assume we eat too much fruit. Not only is that not happening, but it may not even be possible, as the health benefits of fruit are legion. Imagine a sweet burst of juicy flavor that helps to control blood sugar, maintain fullness, regulate digestion, keep skin clear and reduces the risk of heart disease and some cancers. Oh yes, pass that bowl of fruit!

But wait, doesn’t fruit have too much sugar?

This is a common question and one that makes sense given the push to reduce our sugar and carbohydrate intake with programs like the Whole 30 and paleo diets.  Partially this is a consequence of our reliance on reductionism, where the health impact of food is reduced to its component parts. In this line of reasoning, the sugars and carbs in fruit are to be avoided like added sugar in sodas or refined carbs in breakfast cereals. But as the research consistently shows, fruit does not impair health, it promotes it. Here are a few reasons why:

  • Fruit is packed with fiber, slowing down digestion and keeping blood sugar levels from spiking, as well as promoting digestive health and feeding beneficial bacteria in our micro biome.
  • Fruit has multitudes of nutrients, some of which are essential to our health, others that promote optimal immune, cellular, and organ function – from your kidneys to your brain. These are the anti-oxidants and phytonutrients which also provide the color and complex flavors of fruit.

What does the research say?

As with all things food, it is difficult to parse the health impact of one specific nutrient or food group since we eat a wide variety of foods and it may take decades to see an impact on chronic disease. However, here are some of the results from studies on fruit:

  • The health impact of fruit is often combined with vegetables, as in a systematic review of 95 studies published this year in the International Journal of Epidemiology, finding that people who eat more fruits and vegetables live longer and have lower rates of heart disease and cancer.
  • Eating fruit every day decreases the risk of heart disease and stroke by 40% according to a 2014 study published in the European Heart Journal. In addition, those who ate the most fruit had the lowest risk.
  • According to a 2015 CDC report, people consuming at least 2 cups of fruit per day are more like to have a healthy weight.
  • The impact of fruit intake on diabetes risk is a bit more convoluted. Some studies show improved blood sugar control and reduced risk, others find no connection between fruit intake and diabetes. We need more research to have a clear picture for this specific disease.

The take away

Early summer is the best time for ripe, seasonal fruit. Citrus is still going strong while berries are at their peak and stone fruit is ripening away. Here’s how to ensure that you get the most from these natural bundles of healthful sweetness:

  • Eat lots of colors. Variety ensures you consume the breadth of nutrients available form fruit. Color is related to the bioactive compounds that tend to benefit our health.
  • Eat them every day. At least. Aim for a minimum of 2 cups per day.
  • Leave fruit out on the counter. We are visual creatures, engineer your environment to cue to you to eat healthfully.
  • Eat your food, don’t drink it. Juicing concentrates the sugar and removes or at least breaks down the fiber, resulting in blood sugar spikes. Small amounts of juice can be healthy for some people- if you don’t have blood sugar control problems and it fits into your overall eating plan.
  • Turn to fruit for that sweet taste you crave. If you are used to ice cream, cake, and cookies as your treats, this may take some getting used to; but fruit can be a dessert that satisfies the taste buds, the stomach, and the mind. You can feel good during and after you eat it. Often the biggest health benefit is from eating a healthy food in place of an unhealthy one. So replacing sugar rich desserts with fruit will compound the benefits to your health.
  • The perfect snack food. Fruits require no cooking and many have a built in package to keep them fresh on the go.

Happy eating,


You’ve Gotta Connect to be Healthy

Since 2011 Gallop has been polling US adults about their perceptions of well being. To understand physical health, they ask questions about exercise, disease, and diet. Their recent report on these interviews conducted with over 350 thousand people in 2015 and 2016 indicates that many healthy lifestyle factors have actually improved:

  • more people report exercising regularly
  • fewer smoke
  • and more have access to healthcare.

Some not so good news on the other hand:

  • more people are obese
  • have diabetes and heart disease
  • and fewer are eating healthy.

Of course, these are self reports so do not provide an objective view of health. However, they are useful to see trends over time and illuminate factors associated with healthier behaviors; helping us answer the question, how do people who eat healthy live their lives differently from those who don’t?

People who report eating healthy also report strong social connections, having:

  • friends and family who encourage healthy living
  • leaders who make them feel positively about the future
  • strong, and improving relationships with their significant other.

This isn’t surprising, as research consistently shows a link between health, longevity and social connections. Of course, there are many ways to connect with others, but finding social groups (either in person or over social media) who practice healthy habits is a key, according to this well-being poll. Some other ideas for cultivating healthy social connections around food:

Additionally, respondents indicate that health is associated with feeling that personal goals are being achieved and that learning is a regular part of life.  Having a sense that we can improve our lives and make a difference in our communities reinforces motivation and may lead to taking better care of ourselves.

Happy eating,



Starving in the Midst of Plenty


The standard American diet leads to disease. About one out of every two deaths in this country result from heart disease, stroke or diabetes and are linked to poor diet and inadequate exercise. That’s about 1,000 deaths per day. Our food is more plentiful and cheaper today than ever before and yet as a population we are malnourished. While rates of chronic disease continue to rise, we are spending less on our food. Today, Americans spend 9% of disposable income on food, down from 17% in 1960. In this same time period, our calorie consumption has jumped an average of 497 calories per day. So not only are we spending less money on food, but we are eating more of it. Quite a trick that our industrial food system has pulled off.

Malnourished sounds like starvation, not getting enough and wasting away. This is obviously not the problem since only 1/3 of US adults maintain a healthy body weight. So while we get plenty of calories and protein, we don’t eat enough fiber, fruit, vegetables, whole grains, or legumes. The only reason we don’t see widespread nutrient deficiencies is because our processed foods are highly fortified, just enough to keep us alive, but not to prevent disease. And of course, we don’t do much better on the exercise front: only 21% of US adults meet minimum exercise recommendations for aerobic and strengthening activities.

We cannot use medicines to solve this issue, we have to improve our diet and increase our exercise. Until we do this on a mass scale, we are going to continue to have high rates of chronic disease and health care costs.

There are many, many options to improve the health of your diet. The important thing is to pick something and do it. Pick a change – even if it is just one thing- commit to it for a month then evaluate how it went. Don’t wait for the perfect diet to come along or be discouraged or dissuaded by the latest food or weight loss trends. Rely on the basics: eat food, mostly plants, not too much as Michael Pollan eloquently puts it.

Wherever your current habits are today, make a commitment to improving. Be intentional around food, align your food choices to your ethics. What do you want your health to be? What do you want the health of your family, your children to be? Eat that way. Move that way.

If you just go with the flow, eating the average diet, you will be on the path of disease. Step out of the norm and embrace a health focused approach to your food and exercise.

Happy eating,



The Simple Diet for a Complex World

Healthy eating should be simple. Something you’d never know from the thousands of diet books with the latest promise to eat your way to happiness or muscles or thinness or beauty or youth…exhausting, right?

There is a better way. A way where:

You don’t have to count your calories or carbs. You don’t have to maximize your protein or minimize your fat. You don’t have to bullet proof your coffee.

So what should you eat? Simply put- food. If it grew in the ground it’s likely good for you. Can you tell by looking at it what plant it grew from? Then eat your fill. If it comes from a box or a can or an animal, pay attention to what’s in it and how much you eat. Make meats the size of your palm and use dairy as a flavoring.

On the simple diet you eat until you feel full, you eat fresh foods that tastes good and feels good an hour later. Your plate is a bounty of colors and textures.

The complicated part is how different this is from the way most of us eat. The complicated part is that we are surrounded by encouragements to eat highly processed convenience food products. The complicated part is that we think eating simply is more expensive and too hard. The complicated part is that we are out of practice preparing our own meals.

The simple diet may take some investment on your part. You may need to work with persistence and intention to change your eating habits, to wrench control of your meals back from the industrial food giants. Here are a few ways to get started, to shift towards simplicity in your plate:

1. Eat a hearty salad for lunch.

2. Drink water: ditch the soda, bottled drinks and specialty coffees.

3. Do some food prep and planning on Sunday for the week.

4. Prep overnight oats for an on the go breakfast.

5. Keep fresh fruit visible on the kitchen counter and make them your snack food.

6. Bulk up on veggies, at least half you plate; roast them and mix them into your regular meals.

Pick one and give it a try, you will be on the way to a simpler plate.

Happy eating,



Make Each Day Mediterranean

May is Mediterranean diet month and a great excuse to dive into the bounty of spring!

Mediterranean food cultures are beloved for using fresh seasonal ingredients, bold flavors, and enjoying meals with friends and families. These are all key ingredients in any healthy eating plan.

The Mediterranean diet is repeatedly identified as one of the healthiest ways to eat. In both clinical trials and population studies, this eating pattern reduces the risk for all of the chronic diseases associated with nutrition: heart disease, diabetes, stroke, obesity, osteoporosis, dementia, and some cancers.

What is the Mediterranean diet?

This whole food based plan is built around plentiful fruits, vegetables, seafood, nuts and olive oil with moderate amounts of eggs, dairy (yogurt and cheese), poultry and meat. This diet contains lots of complex carbohydrates like whole grains, whole-wheat bread as well as pastas. You don’t see added sugars and highly processed carbohydrates- i.e. processed foods – on this plate. Compared to the standard American diet, this pattern is higher in vegetables, legumes, fruits, nuts and fish and lower in added sugars, processed meats and red meats as well as dairy.

What’s the Evidence?

A very large study out of Spain involving more than 7,000 adults at risk for heart disease compared a low fat diet with a Mediterranean diet. In 2013 after four and a half years, the study was stopped early because the benefits of the Mediterranean diet were clear: a 30% reduction in the risk of heart attack, stroke, and dying from a cardiovascular cause. Studies showing health benefits of the Mediterranean diet have been regularly published for over 50 years.

How Does it Work?

This eating pattern creates a healthy lipid profile in the blood (the good and bad cholesterol), improves blood sugar control, and reduces chronic inflammation. These are the markers of metabolic dysfunction that prevent us from being healthy. The high amounts of vegetables are also linked to healthier gut microbes which we need to keep well fed to maintain our health.

It’s Not One Specific Food:

While there is conflicting evidence about the health impact of specific foods and nutrients like fat or dairy, in reality we eat foods in combination. So it is wise to think about our diets as a whole pattern and not just comprised of individual foods which have independent effects on our health. The Mediterranean diet is also a lifestyle; traditional communities ate together, took their time with meals and moved their bodies throughout the day. No matter what “diet” we follow, regular physical activity, social support, and a balanced relationship to food are essential.

How You Can Eat this Way:

A few simple steps can set you on the path:

• Eat vegetables – aim for half your plate, twice a day. Don’t forget the flavor, you should always enjoy your meals!

• Change the way you think about meat. Reduce your portion sizes and learn that you can be satisfied without a large serving (or any at all) of meat at every meal.

• Eat seafood twice a week.

• Eat vegetarian meals at least once a week. The more often, the better.

• Use healthy fats: olive oil, avocados, nuts and seeds.

• Use whole grains. Experiment with traditional Mediterranean grains like farro, barley, bulgur. Others to try: teff, quinoa, millet, and brown, black or red rice.

• Have fruit for dessert. This can satisfy the sweet tooth while avoiding added sugars.

Learn more at OldWays.org. Where you can find:

  • recipes
  • grocery shopping lists
  • and even test your knowledge on their Mediterranean diet quiz

Happy eating,


A Conspiracy of Love

This is how Dr Dean Ornish recently described his lifestyle medicine program. He has been researching and promoting healthy diets and living for decades. In this time, he developed a program clinically proven to reverse heart disease. He uses a holistic approach, training participants how to:

  • eat better
  • move more
  • manage stress
  • and get social support

His comment about love comes from his experience with patients showing that healing happens when self care and support are central to the process. Without this, we see the high failure rates of people trying to lose weight, trying to exercise more, trying to improve their health. The missing component is often the ability to open up to love of self and others.

The ability to approach difficult areas in your life- lack of exercise, struggles with food cravings, overeating, emotional eating, food addiction- with kindness towards yourself is a path to lasting health. One of the most common reasons people aren’t successful at adopting lifestyle changes is the unavoidable reality of relapse. Whether it’s because you don’t have a well planned approach or you are trying to take on more change than you can maintain, we all fall back into old, often unhealthy patterns in life.

How you respond to these moments of relapse will likely determine the long term results of your efforts. Those who are successful at lasting change cultivate resiliency into their lives and efforts at lifestyle change.

How can you develop a resilient plan?

Two of the four components of the Ornish system address this issue: stress management and love & support. At the SF Free Clinic, we embrace this holistic view of health as well. Our clinic offers yoga, counseling, and mindful eating classes to teach stress coping techniques and provide a community supporting healthy living. Research shows over and over that most of us cannot do this alone. It might take a little humility to admit you need help. This very humility may be the thing that helps you achieve your goals: recognize where you are falling short and how to get support to overcome the barriers.

Happy eating – and loving,