Smart Shopping

There is general consensus in the field of lifestyle medicine and prevention that the most important factor in reducing the high incidence of chronic diseases plaguing our health these days is the type of food we ingest.  Yes there are other factors such as exercise, rest and stress reduction, loving relationships, purpose for living and hope in the future, as well as sunshine, plenty of water and healthy choices.  But our food trumps them all. With the industrial revolution food has changed dramatically.   Fast foods, packaged foods, processed foods are the order of the day.

ALSO READ : Turning the Tide – Dealing with the main lifestyle-related conditions in South Africa (Part 14)

And there is no doubt that these unnatural foods have contributed majorly to the rising incidences of obesity, diabetes, cancer, auto-immune diseases, Alzheimer’s disease, cardiovascular disease, kidney disease, liver disease and arthritis.

Here is a study conducted in 195 countries, showing the effect of dietary practices on mortality as well as disability-adjusted life years (DALYs – a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death). In summary, in the year 2017, 11 million deaths and 255 million DALYs were attributable to dietary risk factors – like excess salt, low intake of whole grains, low intake of fruits – the main factors amongst many.

Today we want to deal with some practical issues of how we can rationally improve the quality of food we ingest for the sake of our health. This is not a “law” of healthy eating, but is a guideline or recommendation to what foods are best for our overall health.  If you are battling cancer or heart disease or kidney failure or diabetes, you will have to be far more strict in your choices.  If you are otherwise pretty healthy, and have a health weight and exercise frequently, then you may not be as strict.  Dr Dean Ornish, the doyen of lifestyle medicine speaks of the “spectrum” – you can choose where you want to be on the spectrum of health and how much you want out of life.

Principle No 1 – whole foods and dried foods

Eating foods in their natural state is key.  The healthiest foods are those that don’t have nutritional labels – things like whole fruits, vegetables, whole grains and legumes.  These are found in the green-grocery part of the supermarket.  There is such a wide variety of foods – fruits, berries, vegetables, starchy vegetables like potatoes, squash, sweet potatoes, mushrooms, etc.  One doesn’t have to buy exotic or expensive fruits and vegetables, or imported products that are not in season locally.  Aiming to get at least 5 portions of fruits and vegetables per day is key to dramatic improvement in wellness.  Some foods are fine raw, but most are better absorbed gently cooked (as opposed to being cooked to death!).

Another group of healthy foods are whole grains and dried legumes – things like dry beans, peas, chick-peas, lentils, barley, brown rice, quinoa, wheat, seeds and unsalted nuts, and dried fruits, herb teas.

Principle No 2 – minimally processed foods

This category includes tinned whole legumes, sweetcorn, chopped tomatoes.  But it also includes such breakfast cereals as rolled oats, perhaps some of the whole-grain breakfast cereals, herb salts and spices, whole-wheat or other whole grain pastas, and some of the pasta sauces.

Principle No 3 – moderately processed foods – to be used sparingly

This category includes whole-wheat bread, or sour-dough breads and buns, breakfast cereals like granola, wraps and pita breads, ready to eat cooked vegetables and stews.

Principle No 4 – highly processed foods – to be used only occasionally

This includes ready prepared commercial frozen meals, fruit juices, oils and spreads, salad dressings, traditional breakfast cereals, soya products (like textured vegetable proteins).

For those who like animal products, fish and lean meats and low fat white meats, skim milk and egg whites. (Although not highly processed, they have significant health issues if taken frequently)

Principle no 5 – ultra processed foods – to be used only on special occasions, or never!

Included in this are products like chips, snack foods, ice-cream, fizzy drinks and cool-drinks, cakes, biscuits, chocolates, puddings, pizzas, burgers, toasted sandwiches, cheese.

These foods are loaded with ingredients that have been stripped of natural fibre and phytochemicals, and filled with sugar and salt and oil, together with all sorts of preservatives.

This is by no means an exhaustive list, but does give some pointers based upon much reading and reflection that I have done.  Please note that this is my own perspective – there are far more erudite authorities who may differ in the details.

As an example of how the processing of foods changes their nutritional value:  According to the United States Department of Agriculture, a large red apple with its skin intact contains about 5 grams of fibre, 13 milligrams of calcium, 239 milligrams of potassium, and 10 milligrams of vitamin C. But remove the skin, and it still contains about 3 grams of fibre, 11 milligrams of calcium, 194 milligrams of potassium, and plenty of its vitamin C and other nutrients.  .  But then when we cook up the apples, we lose some of the vitamins, and concentrate it down so it becomes more energy dense.  If we squeeze out the juice and throw away the fibre, we further concentrate the sugars, and eliminate the mechanism to control too rapid absorption of those sugars.  Of course when you make an apple pie, you add a whole lot of unhealthful sugar and fats and refined flour.

There are some people (like those with diabetes, heart disease, cancer) who are so convinced that they need to make drastic changes in their lives to restore health and vitality, that they give up most of their traditional dietary preferences, and move totally to a plant-based, whole food diet – with very dramatic benefits.  But most people are only willing to make minor changes – perhaps including more fruit and vegetables in their diet, and cutting back on the highly or ultra-processed foods.  Any bit helps, and there will be some benefits, even with small changes.

Healthy eating is a journey.  We can continually grow in knowledge and experience to improve our health and vitality.

Next week we will look at how to read food labels to guide in choosing the best quality foods.

To health and vitality,

Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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