Fat is good, bagels are bad

By Miles Hassell, M.D.
Co-medical director, Providence Integrative Medicine Program

This is adapted from Good Food, Great Medicine, a Mediterranean diet and lifestyle guide and a practical, easy-to-read resource for anyone wanting to eat well without sacrificing eating enjoyment. Readers are offered both the evidence and the tools to help prevent or reverse heart disease and type 2 diabetes, improve cholesterol levels, control high blood pressure, reduce risk of stroke, dementia, and cancer, and lose weight without deprivation.

What is the Mediterranean diet?

Although there is no precise definition of the Mediterranean diet, it is safe to say that there is a pattern common to most Mediterranean regions, and this pattern is consistent with what has been found in published medical studies.

  • High intake of vegetables, fruits, beans (and other legumes), nuts, seeds, and grains (historically mainly unrefined)
  • High intake of extra-virgin) olive oil
  • Moderately-high intake of fish
  • Moderate intake of dairy (historically cultured, like yogurt, kefir, and cheese)
  • Moderate meat, poultry, and eggs
  • Moderate wine, generally with meals

Good food is our best medicine.

However, if we have health problems, excess weight, or a family history of heart disease, diabetes, or cancer, there are a handful of “food rules” that can make a huge difference in our future health. How seriously we take these depends on our own risk factors as well as our decision as to what we want our life to look like in ten years. The following suggestions are in two groups: “What to eat” and “What to avoid.” Note: special occasions like birthday parties (as long as they are birthdays of people you know personally) and holidays are exceptions: in those cases it may be appropriate – arguably even therapeutic – to see how many of these rules we can break at one sitting.

What to eat

Here is an overview of foods that should be in our shopping carts and on our plates.

  1. Eat vegetables with every meal and snack, and eat fruit whole, not juiced.
  2. Eat beans and other legumes daily or at least three times a week.
  3. Eat minimally-processed whole grains and choose unprocessed grains where possible.
  4. Eat good fat, not low fat, with each meal and snack. Use extra-virgin olive oil as your main cooking oil, replacing most other oils and fats. Use butter, not margarine. Eat raw nuts and seeds, avocados, and other healthy fats.
  5. Eat fish, unprocessed meat, and real eggs, emphasizing oil-rich fish like salmon, tuna, and sardines 3–4 times a week, moderate amounts of poultry, pork, and eggs1, and moderate-to-small amounts of red meat.2
  6. Eat dairy, preferably cultured, like plain yogurt and kefir, and aged cheese.
  7. Keep alcohol to one glass of wine (about 5 ounces) daily, with a meal.

What to avoid

The six food categories in the following list are essentially nutritionally bankrupt, and all are associated with worse health outcomes.

  • Sugar, real and artificial, including brown and white sugar, “raw unrefined” sugar, agave nectar, rice syrup, fruit juice concentrate, stevia, aspartame, and so on.
  • Sweet drinks, whether naturally or artificially sweetened, including fruit juices, diet soda, vitamin water, sports drinks, and meal replacement drinks.
  • Highly-refined grains, even if labeled “whole grain,” including commercial breakfast cereals, instant oatmeal, grits, degerminated cornmeal, white rice, white flour, and most crackers, rice cakes, pretzels, breads, and pastas.
  • Highly-processed fats and oils, including most highly-refined vegetable oils, and hydrogenated and partially hydrogenated oils found in most margarine, vegetable shortening, and commercially-fried and packaged foods.
  • Preserved or processed meats, like deli meats, bacon, ham, cured sausages, salami, hot dogs, and most rotisserie chicken.
  • Fake or highly-altered foods, like egg and butter substitutes, non-dairy creamer, meat substitutes like textured vegetable protein (TVP), and artificial sweeteners, flavors, and colors.

Read a more detailed article on this subject with references from peer-reviewed medical literature.

© 2015 Miles Hassell, M.D.