My own odyssey to find a healthier diet began in earnest when I was about 45, back in the late 1990s, when “middle aged spread” started to accumulate, even though I was very active physically. I was able to get down to my desired weight if I was diligent about exercising and watching my calorie intake, but always had to fight off cravings, especially my sweet tooth.
This went on for many years until around the end of 2016 when I had a physical, and my blood work wasn’t great. Bad cholesterol too high, good cholesterol too low, and triglycerides too high. My doc was especially concerned about my triglycerides, and told me to cut back on carbs. That led me to intensify my search for a healthy and sustainable way of eating.
But let’s start at the beginning. Grandma did most of the cooking as Mom was the breadwinner. We followed what was a typical American diet at the time. But there was nowhere near as much fast food available back then. A McDonald’s came in a few miles away when I was about 8, but we considered going there a special treat, maybe once a month. At McD’s back then you could get a small hamburger, small fries, and soda or a milkshake. No big macs yet. And they used to brag about how many millions of hamburgers had been sold, not billions.
We didn’t go out to eat that often in general because of the expense, and because Grandma loved to cook. It was mostly meat and taters; vegetables might be a can of cream style corn or peas. The exception was in the summer when Jersey’s local produce was available and it earned its nickname “the garden state”: amazing local beefsteak tomatoes and corn on the cob headed the list. We also ate a decent amount of fruit.
We drank very little soda because my grandma made a version of iced tea that tasted like the “black tea lemonade” they serve at Starbucks (only she didn’t charge 4 dollars a glass for hers). This probably didn’t save us too much in the sugar department compared to soda, though, because I remember her dumping sugar into the pitcher by the scoopful when she made it
I do remember having a coke from time to time, in its 6 ½ oz. bottle. If you really wanted to splurge you got a large size soda, which was 12 oz. back then. Refined food was definitely creeping in but grandma mostly cooked from scratch. She made a lot of pies, with the crust made with lard, until that amazing invention Crisco came out in 1960. I remember her ladling that glop from the big red can. There were early TV dinners like Swanson turkey in its little aluminum tray with compartments, but again that was only an occasional special treat. No junk food or soda machines in the schools. I took a bag lunch to school, a sandwich on wonder bread, an apple, and some of Grandma’s cookies.
I was 18 and in college when Frances Moore Lappé’s book Diet for a Small Planet came out, arguing that eating plants is more efficient than meat as far as resource consumption, appealing reasoning to a budding engineer. So I decided to be a vegetarian, despite the fact I had no idea how to cook nor knew anything about nutrition other than what I learned from that one book.
There were no tofu, veggie burgers or other meat alternatives in the supermarket back then, and you couldn’t ask for the vegan option at a restaurant, they wouldn’t have known what you were talking about. While I hung in there for about 2 years as a vegetarian, I survived mostly on cheese pizza and meatless Italian dishes like manicotti, which fortunately are plentiful and superb in New Jersey.
After I graduated, Karen and I moved to Pennsylvania. I gave my vegetarianism up, so it was back to the standard American diet. Only now fast food was readily available, and I partook of plenty of it. I did make some efforts to read up on nutrition, eat not so healthy foods “in moderation” and try to get my “5 a day” of fruits and veggies, but it was all pretty half-hearted. I was pretty active in running and bicycling by this time, so I was able to keep this up for many years without gaining weight. I’d go for a half hour run at lunch and I could eat whatever I wanted.
I would visit my brother Bill in Phoenix and we’d go out for a brisk morning run, burning a few hundred calories maybe, then go to a nice restaurant and proceed to inhale a few thousand calories for breakfast. When you’re active and young that math somehow works out. It stopped working after I was about 45. The pounds gradually crept on until I was 25 pounds overweight.
Karen and I both decided to fight the onset of middle aged spread by joining Weight Watchers. They have a point system which back then consisted of tracking the calories, fat, and fiber of your food, and that would get converted to points by a little cardboard slipstick calculator they gave you. You were allocated an amount of points for the day based on your current weight. Remember, I’m an engineer, so I treated this as an optimization problem. What’s the maximum I can stuff into my face without exceeding my points budget?
It turned out the answer, based on the formula WW used back then, was to go very low fat. So I ended up close to following the Pritikin diet, which was well known at the time, because Nathan Pritikin had good success with heart disease patients on this diet . It did not, however, have a particularly good rep for flavor. The movie “Sister Act” with Whoopi Goldberg came out in 1992, where she is on the run from the mob, hiding out in a convent pretending to be a nun. When she tastes her first spoonful of food in the convent she makes a face and says “what is this, a Pritikin order”?
This was in the middle of the low-fat era. I read up on nutrition at this time and there was logic behind this approach if done properly. You were supposed to eat lots of fruits, veggies, legumes, and minimally processed grains, and eat less meat and leaner cuts of it, and avoid processed food and junk like soda or cookies. Pritikin and others like Dean Ornish never said it was ok to eat sugary foods (like “snackwell” cookies) just because it’s low fat. Unfortunately, that was not how low-fat was interpreted by the mainstream and the results had a disastrous effect on the nation’s waistline.
But my Pritikin-like diet worked great for me. I was able to lose all the weight and keep it off for several years, as long as I exercised a lot and diligently counted my Weight Watchers points. Then it gradually crept back on as I again became less careful about what ate. I fought it for many years, keeping my weight and waistline reasonable close to what I wanted (as long as I exercised enough) but always with a few more pounds around the waist than I would have liked. The problem was that I still had cravings, enough to get me to eat too many snacks at night if I wasn’t careful, and need Tums at bedtime.
Let me go into a little more of what I mean by cravings. I have a sweet tooth and a tendency towards binge eating. Not super bad binges, but enough to get me to eat several snacks after dinner and need the aforementioned Tums, as well as torpedo any weight loss efforts. I’d sit down in my nice comfy chair to watch a good show or sporting event.
Then the little voice would start in- I call it my gremlin. “How about some ice cream. Just a little bit. Oh c’mon, it’s low fat what could it hurt?” I’d fight that off for a few minutes then go all right, damn it, I’ll eat a small amount of ice cream. Back to the chair, eat the ice cream. A few minutes later “how about some cookies? Oh c’mon you’ve already blown your calorie budget for the day, you may as well go for it”. Sly little bugger, that gremlin. Some nights I’d fight it off completely, sometimes it would win multiple times and I’d end up with the tums or pepto bismol.
But whether or not it won, this constant battle was a pain in the ass! If I could gut it out and go for a stretch of a few weeks of winning the battle, I could lose some weight, but the gremlin would be back with a vengeance and I’d backslide. But I could still keep things in check as long as I exercised a lot. This went on until the physical and the bad blood work in 2016 that I mentioned above.
OK, Doc says eat less carbs. Reading on nutrition had been a hobby all this time so I tried the carb restriction approach recommended in Dr. Grant Schofield’s book What the Fat, which also recommended lots of veggies and cutting out all junk. I followed this for a couple of weeks and felt great, noticing right away that I had no cravings, so eating this way was effortless and sustainable, and I readily kept it up for 3 weeks. So far so good!
But it didn’t stop there, because there was the complication of my aortic stenosis that I talked about in my heart valve replacement story. I was motivated to see if there was anything I could do with diet to reverse it or slow its progression, so I did some research on that. The chance turns out to be rather slim based on current knowledge, but there was some anecdotal evidence that following Dr. Caldwell Esselstyn’s heart disease reversal diet might help . This is a whole food plant based (wfpb) diet which also emphasizes very low fat. I decided to give that a try.
I discussed the palatability reputations of the Pritikin diet above, and this one could have the same issues if you were strict enough with it. You are supposed to sauté in vegetable broth so you don’t use any added oil for cooking. Dr. Esselstyn’s wife is a great cook so there are many good recipes in the book. And his son, Rip Esselstyn, wrote a book The Engine 2 Diet. Rip was a firefighter serving with Engine 2 in Austin, Texas, and got his engine-mates to eat wfpb, improving all their cholesterol and triglyceride numbers considerably in the process. There are a lot of good recipes in this book also, and between the two books it is entirely possible you could eat this way enjoyably.
I’m not a good cook so I gave up after a couple of botched attempts. I then cheated a little on the oil, using a refillable sprayer so I could use a reduced amount of oil for stirfrys, and allowing some oil in salad dressings, so I did not meet Dr. Esselstyn’s very strict 10% fat target, but was probably reasonably close. This allowed me to come up with more palatable food choices that were easy for a mediocre cook like me to make.
Needless to say, switching to this diet from a low-carb one was a major flip from one end of the spectrum to the other, essentially “restrict your carbs, but plenty of fat is ok” to “eat all the carbs you want as long as they’re all from whole foods, but watch the fat”. I felt great on it also. I still had no cravings, so it was also effortless to sustain. What was in common between this and the low carb diet was emphasizing whole foods and minimizing processed foods. I didn’t go from eating quarter pounders with cheese, but leave off the bun, to eating veggie burgers but the bun is ok. I went from salads and stirfrys with lots of veggies that had meat in them, to salads and stirfrys with lots of veggies and with plant-based protein sources like beans and tofu.
I continued on this diet for several months, gradually losing 15 pounds in the process, and when I went to my Doc for a follow-up, my bloodwork was superb, including good triglycerides. One important thing to point out is that I didn’t start to lose weight eating this way until after a few weeks. But since my major objective was transitioning to a healthy diet, not weight loss, I was able to avoid being discouraged by that. Gradual weight loss did kick in after that. Unfortunately none of this helped the heart valve, which progressed to the point of needing surgery in August 2017.
But I decided my way of eating “ain’t broke, don’t fix it” so stayed with it. I had another reason to continue to be strict about diet: as I mentioned in my heart valve replacement story , I got a “tissue” (bovine) replacement valve, and tissue valves eventually get calcified and no longer open property, just like the original valve they replaced. The mechanism is unclear but thought to be similar to how calcified coronary plaque forms, so a “heart healthy” diet may well also be a “heart valve replacement healthy diet”, and allow me to get more years out of the replacement.
But I’d also had an angiogram prior to surgery that showed my coronary arteries were clear, so I did relax about fat as long as it’s “good fat”. Dean Ornish points out in his book The Spectrum that while very low fat has been shown to work for reversal of coronary artery blockages, it’s not needed for those of us just trying to stay healthy.
One thing that puzzled me was what had happened to the cravings. I had thought they were just something psychological that you’d have to fight off with discipline and good habits. From my description of my “gremlin” above, it sounds pretty psychological to me. It would have been tempting to think “maybe a shrink can put me on some meds, or a support group or meditation might help”. But the little gremlin went away completely when I fixed my diet.
Then I read Dr. David Ludwig’s book Always Hungry?, which explains the biological source of cravings and presents an eating approach to eliminate them. The first step is a stricter diet to address the cravings, and then you can see what works for you long term. It turns out the restricted-carb diet I’d followed prior to doing wfpb was pretty similar to Dr. Ludwig’s first step, while wfpb qualifies for his longer term approach to preventing cravings, as long as you minimize eating refined carbs.
So I’d blundered into the equivalent of his approach on my own. But I now knew I need to be diligent about the “whole foods” part, especially avoiding refined carbs. Shunning these makes me to able to enjoy eating without having to battle cravings.
What I eat now
I follow a mostly wfpb diet, and I am very strict about the whole foods, especially avoiding refined carbs. When I “stray” it is to allow some oils (like extra virgin olive oil or expeller-pressed canola oil), and some animal foods. I do use healthier varieties of meat substitutes like tofurky (which is just organic tofu, spices, and some healthy oil) but try to avoid more highly processed versions such as those containing soy protein isolate.
I eat a lot of stirfrys, salads, and soups as my main course. I eat whole grain cereals (or pseudo-grains like buckwheat), cooked grains like brown and wild rice, Trader Joe’s sprouted whole grain breads, and nuts and seeds (mostly raw). I eat a lot of fruit, some of it dry (unsweetened). With both nuts, seeds, and dry fruits it’s easy to go overboard with the calories, and to avoid this I carefully watch the quantities.
Creamy sauces can be made without oil using avocado, almond yogurt, almond milk or cashews. I eat a decent amount of fat, maybe about 30% of my calories or so. As discussed below, wfpb can be tuned lower fat by adding in more starchy foods (still unrefined) and cutting back on fat sources, or higher fat by cutting back on starch. I personally find that if I go too low on fat, cravings can return.
I don’t eat dairy except occasionally in coffee, and I eat a lot less meat and other animal foods than the average American. The main reason for this is that there is evidence of a connection between excess consumption of animal products and calcification of heart valves , and I would like my replacement valve to last as long as possible.
This is what works for me. But I also firmly believe diet is not one size fits all. For example there are some people that are intolerant to legumes or grains. Alternatives like the paleo diet may work better for them, as described in Rob Wolf’s book Wired to Eat. But that diet is flexible as well, as Rob describes. Because both are adjustable, there can actually be considerable overlap between wfpb and paleo. And both emphasize whole foods and minimizing processed foods. I’ll go over alternatives to wfpb in future posts.
- Monte, T, Pritikin, I, Pritikin: The Man Who Healed America’s Heart, Rodale, 1987
- Esselstyn, C, Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure, Avery, 2007
- Pohle, K, et al, “Progression of Aortic Valve Calcification”, Circulation, 2001