Brandywine Family Medicine Blog

Healthy Lifestyle - Diet, Exercise, Weight, and Supplements

Published 06.11.2021

There are really several components to healthy living. Eating a healthy diet, maintaining a healthy weight, regular exercise, not smoking, not drinking alcohol or only in moderation, not doing drugs, being safe, and keeping up on preventive health.

The basic tenet of a healthy diet is to get 5 servings of fruits or vegetables daily. If you do this the rest usually falls into place. Eat from the outer rim of the grocery store. Roughly 1/2 of what you eat should be fruits or vegetables, 1/4 whole grains, and 1/4 protein like lean meat, fish or dairy protein. Before you get in line at the checkout line make sure that is what your grocery cart looks like. Put the junk back. No one needs to eat junk food daily like cookies, cake, chips, crackers, ice cream. These are rare treats. If they are not in your house you can’t eat them. You don’t have to cook from scratch every night to eat healthily. Cook in batches and freeze your own healthy frozen dinners. Soups and stews and stir fry freeze well. Try to put three servings of vegetables in everything you cook. Add onions peppers and mushrooms to spaghetti sauce. It is easy to make a couple of gallons at a time and freeze. Then you just have to heat up the sauce and cook the pasta and add some salad and you are done. Make stew with potatoes, carrots, celery, onions, and tomatoes. Make soup with lots of vegetables. If you live alone it is hard to keep fresh salad makings around unless you shop often, but plan some days of healthy salad or make salads your take out night meals. Salads in restaurants are very deceiving though. A few pieces of lettuce doesn’t make something healthy. A salad with cheese, croutons, lunch meat, nuts, and dressing can easily have more fat and calories than a burger and fries. Watch sauces and cheese on foods. Eating a lot of grilled meat isn’t good for us either. Baking, broiling, or frying in a ceramic non-stick pan with a small amount of oil is better. If you get pizza skip the meat and add lots of vegetables on top like mushrooms, peppers, squash, eggplant, and broccoli. Grab a salad to go as well.

It is cheaper to eat healthy from food you buy at the grocery store then eating take out from most restaurants. For a quick cheap meal, there is always peanut butter and jelly on whole wheat with an apple or carrot sticks. A big bowl of oatmeal with some cupcake sprinkles and a fruit snack plate was always popular with my kids when I didn’t feel like cooking.

Processed meats like bacon, sausage, and lunch meat are bad for us. They have lots of preservatives and nitrates in them that increase your risk of esophageal, stomach, and colon cancer. Fresh and frozen meats are the best.

Low-fat dairy products like yogurt and cottage cheese are good but high-fat dairy like sour cream, ice cream and cheese are not. Eggs are ok in moderation, it is the cheese and breakfast meat like ham, bacon, and sausage that you have with them that are bad.

Junk food is just that. It has no nutritional value at all and is just empty calories. There is nothing in a Dorito that is good for you. Pretzels and crackers are ok in moderation but watch the serving size. Don’t sit down with a bag of goldfish crackers and absently eat while watching tv. Baked goods have no value in your diet and should only be rare treats. Like once or twice a month. Ice cream is something you go out for as a treat not a half gallon in the freezer. Instead try making frozen yogurt at home with regular or almond milk, vanilla yogurt and frozen fruit. It just needs to be served quickly. You shouldn’t eat anything sweeter than a piece of fruit. Remember a serving size of ice cream is half a cup. Most people dish out 2-3 servings at a time.

Whole grains like brown rice or wheat pasta are always better choices than the white processed flour type but you have to watch the amount of added sugar added to whole wheat bread to make it palatable. Sometimes plain whole grain white ends up better. Bread products are loaded with preservatives. Real bread molds in just a few days but it is worth making yourself if you have the time and the freezer room.

Spaghetti sauce with lots of vegetables on pasta so there is more sauce than pasta and preferably a salad is a healthy meal. Sauce out of a jar on a big pile of pasta with garlic bread is not a healthy meal. Jarred sauce has lots of added sugar and almost no vegetables.

Don’t drink your calories. Flavored coffee drinks have tons of fat and sugar in them and can have 500 calories per serving. Frozen coffee drinks are just like drinking a milkshake. Commercially prepared smoothies have lots of sugar in them and thickeners and little fruit and vegetables. Make your own at home - they are delicious.

Five years ago I lost 70 lbs in a year by drinking spinach smoothies every night for dinner for a year. I have now gained about half of it back but I never got tired of the smoothies. They were delicious, but I hated cleaning the blender every night. I put a handful of spinach, carrots, an apple, vanilla yogurt, frozen fruit like peaches, strawberries, or mixed berries in the blender along with dilute juice like orange pineapple and mixed it up. They looked purple green but the taste was great. Not too sweet but very filling. I was not hungry. If I wanted something to chew I would make a small batch of popcorn on the stove to have with it. The fiber keeps you full. Microwave popcorn has some bad fats in it for you. The kind you make on the stove or in a popper or microwave air popper with a little oil is better.

There are many components to living a healthy lifestyle. Don’t view it as an all or nothing project. It is more work eating healthy and often more expensive. McDonald's is really cheap food - I get it but if you can eat healthy 90 % of the time that is a reasonable goal. Maintaining a healthy weight is a struggle for a lot of us. If you are overweight you eat too much. You are taking in more calories than your body needs and you are storing the excess calories as fat. It isn’t the healthy way but you can lose weight by eating junk food - you just have to cut back significantly on portion sizes until you start losing weight. You can lose weight just eating candy if you are only eating about 1000 calories a day of it. You will lose weight but feel horrible. You will have headaches, your blood sugar will drop at times making you feel nauseated and weak and you will be hungry all the time. It is far better to eat a healthy diet with fiber to keep you full and protein to keep you going.

At the beginning of every year I see people trying to get healthy. They join a gym and say they will go 5-6 x a week. They vow to cook every night. They make a goal of losing 10 lbs in a month. If they struggle and it falls apart they quit everything. It isn’t all or nothing. Do what you can and set reasonable goals for yourself. Cook on the weekends and freeze some healthy meals for during the week. Write down a list of healthy meals and keep it inside a kitchen cabinet to give you some good ideas when you walk in the door from work. Plan ahead but don’t assume you are going to cook from scratch every night. A reasonable weight loss goal is 1-2 lbs a week. You have to look at achieving a healthy weight as a permanent lifestyle change not a diet that you are going to stop at some point. The change has to be sustainable. That is why keto and Atkins are so bad. You just can’t keep eating like that long term. Unless you really stick to that tight carbohydrate restriction you will end up having your cholesterol go up and regain a lot of weight. I have never had a patient be able to stick with a keto diet for more than a couple of months and most people then regain most if not more weight than what they lost.

We all should be exercising and moving 30-60 minutes or more every day. You don’t have to go to the gym to do this. Few people can keep up that commitment especially if you have kids. You are exercising when you get and keep your heart rate up to 120 or more for a sustained period of time. Walking around the house is not exercise. Exercise is when sweat is running down your neck and you are breathing hard. Strolling around the block doesn’t get you there either. You have to walk briskly like 3 or more miles an hour to get your heart rate up and keep it there. The people who I have had be the most successful at losing weight long term either walk 3-4 miles a day or do exercise videos at home early in the morning when no one else wants your attention.

You can get exercise around the house scrubbing the floor especially when you get down on your knees to get the nook and crannies. Scrubbing down the bathroom, vacuuming and moving furniture washing the car and really scrubbing it. Washing windows, mowing the lawn, raking leaves, digging and planting bushes, painting the house, cleaning out the garage. All this counts as long as you get sweaty doing it.

Get up and move at least 10-15 minutes every hour. Stand at the computer, go up and down the stairs for no reason, take a short brisk walk as a break from work. Try to get the 10000 steps a day on a fitness tracker. Get down and do fifty sit-ups and push-ups. Just get moving.

Vitamins and supplements are not needed if you remotely eat a somewhat balanced diet. You are just peeing and pooping them back out. About the only people who need vitamins are those who have had bariatric surgery, people who have had large amounts of their small or large intestines removed, people with inflammatory bowel disease or malabsorption syndrome. Taking vitamins does not negate the badness of having a cheesesteak for lunch.

All women who may get pregnant whether planned or unplanned should take 400mcg of folic acid daily for at least three months prior to conception to help reduce the risk of neural tube defects like spina bifida in a baby. We have found the synthetic form in pills is more effective than what is in fresh fruits and vegetables.

Women should get about 1000 mg of calcium a day in their diet through either food or supplement but more is not better and can actually increase your risk of coronary events and kidney stones. A serving of dairy like 8 oz of milk, 5 oz of yogurt or 1 oz of cheese all have about 300 mg of calcium in them. A serving of green leafy vegetables like broccoli or spinach also has about 300 mg of calcium so three servings a day of one of these foods is all you need.

We used to recommend fish oils, coQ 10 and niacin to reduce the risk of heart disease but found it didn’t really help anything.

Vitamin D is a big one in the last few years. We make the active form of vitamin D in our skin when exposed to sunlight. Vitamin D deficiency is more common in darker skinned people and in people who live in a northern location and almost everyone is vitamin D deficient by the end of winter. Taking vitamin D through doesn’t tremendously help anything. If you take a group of vitamin D deficient people and put them on a supplement none of their health outcomes improve. Not bone density, mental health or general well being. The only group that may get some benefit are the elderly in nursing homes have a slightly decreased fall risk with taking vitamin D. Just get out there and take a walk on sunny days, even in the winter. Look up, obviously not looking directly at the sun, but let the bright sun shine on your face for 30 minutes a few times a week. That does help mood and well being.

It always amazes me the bottles of stuff people bring in to show me what they are taking. They don’t want to take pills for high blood pressure or diabetes but will take some unknown product they bought online. Supplements are a totally unregulated industry. There is no quality control. You have no idea what is in the pills you buy. When independent labs test a lot of products they find potentially cancer causing agents, pesticides, heavy metals like lead and arsenic. Anybody can bottle pills and sell them. They answer to no one. Certainly, there are reputable companies out there like Natures Way and One a day that you can trust but any small batch company can claim anything. They can say they are independently tested and they don’t have to be. It can just be a lie. They can say their product has been tested and studied and it has not. A pill or capsule can come from weeds cut along I95. You just don’t know. Many energy pills contain illegal drugs like crack or amphetamines. Many thyroid support products often contain dried pig or cow thyroid tissue which can make your own thyroid go crazy. The FDA has no control over the supplement industry. They can only get something off the market if it has caused several deaths.

Patients are concerned about putting drugs in their body but drugs are chemicals and everything is made of chemicals, food, trees, bushes, rocks. Know what you are putting in your body. For a prescription medication to go to market it has to prove that it is both safe and has benefit to the FDA. It has to undergo ongoing safety monitoring and testing. Each batch has to be quality controlled and tested. They can’t change the manufacturing process without going back to the FDA for review.

There are none of these safeguards in the supplement industry. There are many supplements out there that can cause liver damage, even if taken as recommended. They can cause kidney damage. They can interact with your prescription medication and cause dangerous side effects. Many diet pills can increase your risk of abnormal heart rhythms and elevate blood pressure. People die from supplements. Just because it is “natural” doesn’t mean it is safe.
For the majority of people taking vitamins and supplements, it is a waste of money with some potential of harm.

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