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 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,



Listen in on the Food Revolution

This week you can engage with some of the top thinkers and writers about healthy eating and sustainable food systems in this 6th annual free online summit:

Each day through Friday you can watch live broadcasts of interviews with three experts on how food impacts your health and the health of your world. If you can’t listen live, the interviews will be available for replay the rest of the day.

Some of the doctors and advocates that I follow and write about on this blog will be presenting:

This is just a sampling, there are many, many more. You will also find talks on:

  • food justice
  • the psychology of eating
  • how to support a sustainable food system
  • preventing animal cruelty
  • embracing life through healthy choices

Maintaining a healthy, intentional lifestyle requires regular inspiration and attention. Events like these help us focus on what really matters us, what drives our efforts to improve our lives and our communities. I find support from these creative people; inspiring me to think hard about my food and my place in the world. I hope you find some new knowledge and perspectives to live with intention.

Happy eating,


Sugar and the Brain

Two studies published this month shine a light on yet another negative impact of sweetened drinks, both from added sugars and artificial sweeteners.

First, the sugar research.

In a study of sugary drink consumption with four thousand participants, people who consumed the most had:

  • Accelerated brain aging
  • Poorer memories
  • Smaller overall brain volume
  • Smaller hippocampus – the region of the brain associated with learning and memory.

These anatomical changes are all known as risk factors for Alzheimer’s disease. And it doesn’t take much to cause damage; as little as four sodas per week qualifies you for this high intake group.

And the research on diet soda.

When trying to cut back on sugar, many people turn to diet soda as a substitute; but a follow up study found that those who consumed one diet soda per day were three times as likely to have a stroke or develop dementia. Surprisingly, this study found no correlation between sweetened beverages and dementia or stroke.

Keep in mind that with population studies like these, we can’t say conclusively that the sugar or artificial sweeteners are causing these brain damages. The researchers note that the drinks may be creating some vascular disease which impairs brain function. In addition, these studies used soda consumption as a stand in for overall sugar intake, but did not evaluate other sources of added sugars or artificial sweeteners.

However, we have consistent and compelling evidence that excess sugar increases the risk for diabetes, heart disease, and obesity. How much counts as excess? The answer likely depends on you: your health condition, your genetics, what you eat, and how much you move. These studies provide another piece of evidence that what we eat affects all of our body organs, including the brain.

While you are not drinking soda, here are some ideas of what to eat instead:

Happy eating,


Eat Your G-BOMBS

What do these six foods have in common?

Dr Fuhrman

They are part of a daily healing, revitalizing, energizing, disease prevention plan.

Dr. Joel Fuhrman created G-bombs as a cancer prevention aspect of his  micronutrient dense eating plan. These immune boosting foods contain an abundance of vitamins, minerals, and phyto-nutrients that provide our bodies with the optimal fuel to function at our best. While we can isolate and identify many of these chemicals in foods, their true health benefits come in their synergy. That is, they work together in the amounts contained in foods to create a bath of nutrients for the optimal functioning of our cells.  These food derived chemicals help our cells fight disease, process sugars and fats in the blood, build muscle, clear toxins, and really every other function we need to live at our best.

Another way to think of micronutrient dense foods is based on color. Make sure your plate contains at least three different colors of whole foods and fill your shopping cart with at least one food of each color group every time you shop:

 Purple, blue, deep red

 Leafy greens

 Yellow and green

 Orange

 Red

Follow either of these two plans to boost your immune system, brain function, reduce chronic inflammation, improve blood sugar control, reduce cholesterol, improve digestion, and feel better!

Happy G-Bombs-


Oldschool Lifestyle

This month marks the 20th anniversary of the DASH lifestyle plan, a diet that is clinically proven to prevent disease, follows generally agreed upon dietary principles, and has loads of free online support materials. And yet, few Americans follow it and not enough health professionals promote it (most primary care physicians counsel low sodium diet for reducing high blood pressure).

As a recent editorial in The Journal of the American Medical Association points out, the DASH diet needs a re-branding. And really, they write themselves:

My that diet is DASH-ing.

DASH to your health.

Eat like this to DASH your high blood pressure.

Why haven’t we embraced DASH? Maybe it’s in the name: Dietary Approaches to Stop Hypertension doesn’t sound too enticing, it doesn’t identify what you will be doing or eating- or not eating- as most much more popular diets do. It doesn’t have an easy one liner like Atkins: the low carb solution or Paleo: eat like a caveman. DASH: eat like a sensible person who cares about their health. Hmmm, not likely to catch on. The focus on high blood pressure makes most people think the diet is about cutting down sodium, which it will do, but is not really the focus and is just one aspect of a complete dietary approach that provides the health benefits of the symphony of nutrients provided by whole foods and plentiful plants.

The hype is real. If you follow this diet you will:

  • lower your blood pressure (40 million Americans have poorly controlled high blood pressure, a primary risk factor for stroke and heart disease).
  • decrease LDL “bad” cholesterol in the blood
  • prevent heart attacks and stroke: a 2003 study indicated 300,000 cardiovascular events could be prevented if people with high blood pressure followed DASH.
  • lose weight (especially if you incorporate exercise)
  • while similar dietary patterns have been shown to also:
    • reduce your risk of cancer and diabetes
    • promote strong bones

What is the diet?

You eat lots of foods rich in potassium, calcium, magnesium and fiber:

  • beans
  • nuts
  • fish and poultry
  • vegetables
  • fruits
  • low fat dairy
  • whole grains

While limiting foods high in saturated fats, sodium and refined carbohydrates:

  • high fat meats and dairy
  • added sugars
  • processed foods

Studies showing the health benefits of the DASH diet reinforce our understanding of the power of whole foods to protect our health. What’s more, you don’t have to follow the diet 100% to gain the benefits. The more you move your diet toward this goal, the healthier your heart, metabolism and blood vessels will be.

So eat more vegetables, fruits, lean meats, beans and nuts while eating less processed food and less high fat animal meats and dairy. And don’t forget to enjoy your meal!

Some of the many free resources:

Happy eating my DASHy friends!


Systems Not Goals

Goals are notoriously easy to set and just as easy to fail to achieve. As I’ve discussed in prior posts on the lack of benefits from focusing on body weight as THE marker for health, having goals can be counterproductive for many of us. We get caught in a cycle of goals setting and failure, reinforcing the common belief that it is just too hard to make lasting lifestyle changes. One solution to this psychological reality is the concept of prioritizing systems in our life instead of goals. In this way, we can create new habits that lead to lasting change – the “how” part that is often left out of lofty goals.

To follow this method to improve your health, instead of focusing on the goal of “getting my cholesterol into normal range” or “getting to a healthy BMI” you would reverse engineer the solution. Think of what you need to do to accomplish these goals. What types of lifestyle changes will reduce your cholesterol or your body weight? These are the systems, and they will be unique to you and the realities of your life.

How to create healthy systems:

  1. First, what do you want to accomplish? Yes, this is the goal setting we are avoiding, but stick with me as we will be letting this recede into the background. An example from my life is that I wanted to find a way to be less stressed, to be able to navigate my day without so much tension and anxiety.
  2. Pick a strategy. You may want to do a little research at this point, find out what experts or people you know recommend for making the change you are looking for. I decided that meditation would be effective, and I had tried it out before and kind of sort of liked it. Or at least felt like I could reasonably give it a try. This is important, bringing a dose of realism to the system you choose will increase the likelihood that you will incorporate it into your life.
  3. Evaluate the barriers. What are the realities of your life that make it harder for your to incorporate your strategy? It might be your schedule (no time), a lack of ability (I don’t know how to cook), or a lack of motivation (I get lazy at night and don’t feel like exercising). For me, I would often forget to meditate, and I wasn’t really sure I knew how to do it “right”.
  4. Create your system to overcome your barriers and make the strategy part of your daily routine. You may need to increase your skills or knowledge or change your schedule.  I decided to make meditation the first thing I did every morning – even if it was just for one minute. In addition, I added a meditation podcast to my commute listening routine to increase my understanding of the techniques.
  5. Revise and perfect. As you go along, the system you are putting into place needs to adapt to you and the changes in your life. It may be that you were too ambitious and need to make it simpler, or that you incorporated the changes easily and need to create new ones to keep moving forward. The key here is that you have a dynamic system that allows you to change and not fall into the failure trap.
  6. Practice, practice, practice. It takes time to cultivate new habits and create new lifestyle practices. The real path to successful health improvements is a longterm view. This is not a “crash diet”. You are making changes that will benefit you for the rest of your life. Today, I meditate for 25 minutes every morning- something I never could have imagined when I started out last year.

Learn more here –

Happy eating (and systems creating)!