Nutrient Density and Metabolic Syndrome

By Brian Morris, MD

There is more to healthy eating than simply the net balance between calories in and calories out. Nutritionists are often divided into two camps when it comes to determining what constitutes healthy eating. Within the first camp are those who focus mainly on calories. The second camp of nutritionists focuses less on the number of calories and more on the nutritional value of each calorie. As in most areas of life, the truth lies somewhere in between. It is important to find a balance between consuming the correct number of calories (habit 1) and consuming the healthiest types of calories (habit 2). In the previous habit, I discussed the importance of eating the correct number of calories each day. However, all calories are not created equal. Some calories are chock full of nutrients and promote good health while other calories are overly processed and are loaded with unhealthy sugars or fats. A small cookie may have the same number of calories as a cup of broccoli, but clearly the broccoli is a much more nutritious option. In addition to consuming the correct number of calories each day, you also want to focus your food choices on calories that are “nutrientdense.” A convenient list of these foods can be found at the end of this section. The majority of your calories should be from these foods as they are loaded with healthy nutrients which nourish your cells and your health. These are the calories that promote health, longevity, and optimal wellness. Avoid “nutrient deficient” calories which have little nutritional value. Examples of “nutrient deficient” foods include cookies, pastries, breads, and highly processed foods. Of course, when deciding what foods are appropriate for you, you should first consider your own unique situation. Any food to which you are allergic or sensitive should be avoided. Foods that elicit an allergic or sensitivity reaction contribute to inflammation and aging and are not healthy choices for you. Nutrient-dense foods include an assortment of options such as spinach, broccoli, kale, tomatoes, avocados, apples, peaches, oatmeal, Greek yogurt, ocean-raised salmon, egg whites, legumes, almonds, walnuts, garlic, berries, and olive oil. These are just some examples of healthy calories and there are many other tasty, healthy options to consider.

You may have noticed several commonalities among each of the foods that I mentioned as being nutrient-dense. First, “good calories” are real food. They appear on your plate pretty much in the same form that they emerged from the Earth. A good rule to remember is that whenever food is processed, it loses nutritional value. A good example of this is oatmeal. In the grocery store, you will find many different types of oatmeal, with the healthiest type being steel cut oatmeal that typically takes about thirty minutes to cook on the stove. Steel cut oatmeal means that the oats have not been processed, so what you see is what you get. The oat was cut into pieces instead of rolled flat during the manufacturing process so you get all the healthful qualities of the oat. Rolling the oats requires a steaming process that may remove some important nutrients. You will also notice instant oatmeal where you simply add water to the oatmeal powder. This sort of oatmeal is a decent breakfast option, but most instant oatmeal has been highly processed. A good rule of thumb is try to purchase oatmeal with the fewest listed ingredients. In general, the fewer the ingredients and the more often the word “whole” is used, the more nutritious and less processed the product is. Start thinking of your food choices in these terms and try to choose the least processed, most nutrient-dense foods whenever possible. Second, “good calories” tend to be colorful. UCLA’s Dr. David Heber wrote a very useful book called What Color Is Your Diet? in which he discusses the health benefits of eating foods of a variety of colors such as reds, oranges, yellows, and greens. In general, the more colorful foods tend to be the foods richer in nutrients while the less colorful foods—the “white foods”—tend to be the more processed, less nutritious choices. Third, “good calories” tend to be more filling. When you eat good calories, you’re more likely to feel satisfied and be more in control of your portion sizes. One of the main reasons so many people gain weight is that their portion sizes are simply too large. Foods that have little nutritional value don’t contribute to making you feel full so you are likely to eat large portions. However, simply eating a variety of nutritious, colorful foods makes it much easier to feel full and to keep portions under control. No matter how delicious, it is more difficult to overindulge in a salad than in cheesy lasagna.

As a part of the discussion about getting the optimal amount of nutritional value out of foods, I should also bring up the role of vitamins and supplements. Supplements are generally extremely popular, but take a secondary role in The Wellness Code. We’ve previously discussed the four-legged stool model of comprehensive care where the second leg of the stool includes supplements along with medications. Thus, supplements do have a role in the care of some patients, but let’s explore this in more detail. Vitamin A, vitamin E, vitamin C, and other vitamins, are extremely important to the functions of life. For your brain to work properly, you need to have sufficient vitamin levels in your bloodstream and internal organs. For your muscles and heart to work properly, you need sufficient vitamin levels. The same applies to your immune system. Many studies show that people who don’t have sufficient levels of certain vitamins have a significantly greater risk of medical problems. Also, there are many studies showing that cells in a laboratory setting function better when certain vitamins are added to the cells. However, remember that these studies are performed in a lab and are not clinical trials involving real people in real life conditions. It is very interesting that vitamins don’t seem to be nearly as helpful when we look at high quality clinical trials. How can we reconcile the fact that adding vitamins appears to help in the laboratory, but not so much when tested in people? It has always seemed odd to me that we would assume that just taking a vitamin by itself would provide the same health benefit as getting that vitamin from food. The reason is that life doesn’t work in a vacuum, but in a complex, interdependent way. For example, when you eat an orange, you get far more nutritional value than just vitamin C. The orange provides many other vitamins and cofactors necessary for the vitamin C to work properly in the human body. In addition to vitamin C, oranges contains vitamin A, thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), vitamin B6, folic acid (vitamin B9), choline, vitamin E, calcium, iron, magnesium, manganese, phosphorus, potassium zinc, lutein, and flavonoids. For the vitamin C to work properly and provide optimal nourishment to your body, it must be accompanied by the other vitamins, minerals, and naturally occurring cofactors that are found in an orange. This is why isolating and purifying one vitamin doesn’t seem to work nearly as well as eating the foods that are rich in that vitamin. There are exceptions and circumstances where certain supplements are needed. However, vitamins and minerals should generally be obtained through food whenever possible.

The goal is to start thinking of life as an interdependent world where each action leads to another action, and another, and so on. Isolating individual elements ignores the reality of how life really works and the relationships that exist between each component of nutrition. As you focus your attention on eating foods with the most nutritional value, it is also essential to pay attention to how nutrition interacts with other elements of a healthy lifestyle such as exercise, sleep, stress, relationships, and so on. The flip side to this is to understand which foods you should avoid. The general rule is to avoid processed, empty-calorie foods such as white rice, pasta, bread, preservative-rich prepackaged foods (cookies, pastries, and candy bars), and high-fat animal products (especially processed meats). If these foods dominate your diet, it becomes challenging to consume the optimal number of calories each day. Foods devoid of nutritional value do little to reduce cravings and can actually increase hunger and lead to overconsumption. For instance, many people think that diet soda can help limit calorie consumption and be a part of a healthy weight loss program. However, it turns out that consuming diet soda actually increases your chances of gaining weight. How can that be? Diet soda speeds up your digestive system creating a sort of laxative effect which makes food move through your stomach more quickly. More rapid movement of food through your digestive tract means your stomach empties more quickly, leads to increased hunger, and makes it more likely that you’ll eat too many calories. One thing to keep in mind when you seek to eat the “good calories” is that beverages such as soda, juice, and alcohol can take up a huge portion of your daily caloric allowance without adding much in the way of nutritional value. When you stick with nutrient-dense foods, you’re much more likely to keep your calorie consumption in line. These foods tend to be naturally low in calories, so you can eat more food and feel satiated. In addition, these foods provide a variety of important nutrients.

Try your best to choose nutrient-dense, colorful foods that are packed with antioxidant and anti-inflammatory properties. Replace “white foods” with foods such as fruits and vegetables, legumes, fish, and lean chicken. Get as much color as possible onto your plate. Aim to have a salad either with lunch or dinner. Make fruits and vegetables your snack foods of choice rather than processed options like candy, crackers, or chips. Have a bowl of oatmeal with some berries (such as blueberries, blackberries, and cranberries) each morning.

It’s also important to make sure that you have the optimal mindset when it comes to making food and beverage choices. By this, I mean that you should make your choices based on what is most nutritious rather than what is most tasty. Many of us grew up making food choices based solely on taste. Comfort food is based on eating what you think would taste the best and make you feel a certain way. Sometimes you just feel like a cookie, a steak, or a slice of pizza. Of course, food should taste great, but taste shouldn’t be the only basis on which you decide what to eat and drink. Your choices should instead focus on what is most nutritious for you. Making choices based on what is best for you is a major paradigm shift in the direction of wellness. The next time you open the fridge, try not to focus only on what might taste better, but instead think about what might be best for you. That doesn’t mean that you always reach for a kale salad, but be sure to keep your health in mind when making food choices as often as possible. You will find that this shift in your mindset will help you be successful over time. Remember the two general principles for a healthy nutritional plan: eat the correct number of calories and also make these calories as nutritious as possible.