Mark Bittman and doctor David L. Katz patiently answer pretty much every question we could think of about healthy food.

 

What about coconut oil? First I heard it’s good for me. Then I heard it’s bad for me.
There’s certainly no evidence it’s “good” for you, but organic, cold-pressed varieties are probably not “bad” for you, either. But olive oil and cold-pressed canola oil are better choices.

Organic, obviously. Even I know that organic is better. Right? It’s certainly more expensive. Tell me it’s better.
Yes. Unquestionably. For many reasons, including that organic farming protects farmworkers from harmful pesticides. There are also clear environmental and ethical benefits.

But … is it healthier?
Proving specific health benefits for organic food is nearly impossible: Imagine a randomized trial comparing only organic food to no organic food, but exactly matched in every other way.

Okay, I’ll stick with organic. Should I take probiotics?
We know pretty reliably that bad microbiomes are common, and that the “right” gut microbes foster good digestion, robust immunity, better sleep, and even weight control —

Okay, sounds good, but — what about probiotics?
In order to foster a healthy microbiome —

Yes, okay, but — what is the microbiome?
Your microbiome is the ecosystem of diverse bacteria that flourishes, quite naturally, in your digestive system. It’s a part of you; as you get healthier, so does it — and quickly. Whole foods, minimally processed, mostly plants, and plain water are good places to start.

One of the current gimmicks — which helps to sell books — is the idea that you have to eat to feed your microbiome. But let’s face it: every wild species on the planet knows what to eat, and none of them know anything about their microbiota. They eat the foods to which they are adapted, and the bugs adapted to live inside them thrive as they do. There’s a lesson for us there: fixing what’s broken is good, and probiotics may be one way of doing it. A balanced diet is a near-certain way.

Okay — so what are probiotics again?
Probiotics are supplements that encourage the repopulation of a healthy microbiome. Think of it like putting high-quality grass seed on a distressed lawn.

Can you “overdose” on probiotics?
In theory, an overdose could result in something called a “dysbiosis,” where the gut is overgrown with an imbalance of organisms. But it must be very hard to do, since we’re not aware of any cases.

What happens if I eat too much yogurt?
We have no idea. Probably you get full.

What about vegetables? I’ve heard frozen can be healthier than fresh — is that possibly true?
There are instances of frozen vegetables being of higher quality and higher nutritional content than “fresh” vegetables. This is particularly true when produce is “flash frozen,” meaning frozen quickly at very low temperature right after harvesting. Age is everything, and freezing retards aging. So, “fresh” produce that comes from far away is likely to lose some of its nutrient value during the transit time, whereas frozen produce is more likely to preserve the nutrients it had at the start of its journey. The best vegetables are likely to be fresh and locally sourced, but flash frozen is nearly as good, and those “fresh” vegetables that spend a long time in storage or transit are probably the least nutritious.

Does cooking food make it less healthy?
Yes and no: Heat can damage some antioxidants, so raw berries are more nutritious than cooked. But cooking can make some food more nutritious: We can’t even eat (let alone digest) dried beans and lentils without cooking them; but cooked, they’re among the most nutritious and health-promoting of all foods. The antioxidant that makes tomatoes red, lycopene, is more “bioavailable” (our metabolism can access it more easily) when cooked than when tomatoes are eaten raw. Cabbage and other brassicas — including broccoli and most dark, leafy greens — are more readily digested with gentle cooking as well.

What about soy? Is soy good or bad for me?
Soy foods come in many varieties, and many are highly processed, so suffer the same liabilities of all highly processed foods; they’re high in refined starches, heated oils, added sugar and salt, and low in nutrients and fiber.

So what kind of soy should I eat?
Traditional soy foods such as tofu and tempeh are good for you, largely because they provide sound nutrition and because they usually displace meat. Soy as a supplement is less clearly a good idea.

I heard that processed soy products are linked to cancer.
The estrogen-like compounds in soy can promote cancer growth in animals in labs, but the net effect of eating foods like tofu and tempeh is less cancer, not more.

Here’s a stumper. I always hear I should eat more fish for lean protein. But then I also always hear that too much fish exposes me to toxins like mercury. Which is it?
Fish is unquestionably the healthiest animal protein to eat. However: There are huge sustainability issues, and some fish — especially large, predatory fish, like big species of tuna and mackerel, and swordfish and shark — concentrate mercury by eating smaller fish.

That doesn’t really answer my question.
Like anything else, fish shouldn’t be eaten three times a day. Should it be eaten once a day? If it’s your only animal product, and it’s sustainable and not otherwise tainted, yeah. Smaller fish are far less likely to contain mercury than big ones.

How can I find out if it’s otherwise tainted?
There are good online sources about such matters: Here’s one, and here’s another.

Maybe I should just skip the fish and take fish oil supplements instead.
Many high-quality fish oil supplements are tested to be contaminant free. However, sustainability of fish or even krill to produce fish oil is a concern, so if you want a supplement, think about getting omega-3s from those produced using algae.

Algae supplements?
Yes.

Speaking of supplements, how am I supposed to get my vitamin D when it’s winter and the sun has disappeared and I’m sad?
Stand-alone supplements of vitamin D3 are safe, effective, and inexpensive. Many foods, and most milk, are vitamin D–fortified as well.

What if I hate lettuce? Do I really needs to eat my greens?
Greens are all good, and one of the few foods you can eat pretty much without limit. These plants are all very low in calories and highly concentrated in diverse nutrients: antioxidants, fiber, vitamins, and minerals.

What are the best antioxidants to take and what are easy ways to get them in our diet?
Eat a variety of vegetables and fruits and you’ll get all the antioxidants you need. There is no good evidence that antioxidant supplements confer the benefits of a diet rich in antioxidants. Other good sources include coffee, tea (especially white and green), dark chocolate and cocoa, whole grains, legumes, nuts and red wine.

Wine! I’ve heard moderate alcohol consumption is good.
Alcohol is the quintessential double-edged sword: There’s a chance for some benefit, but there are risks as well. There’s the relaxation factor, which is immeasurable, and the consensus, which is pretty clear, is that “moderate” consumption may be beneficial and, even more likely, isn’t harmful. “Moderate” means two glasses per day for men; one for women. (Men have higher levels of alcohol dehydrogenase than women, and thus metabolize alcohol more efficiently than women.) There is an association of almost any level of alcohol intake with increased cancer risk, including breast cancer in women and of course liver cancer.

So what is the healthiest alcohol? Is tequila as clean as the hype? Should I aim for low carbs or low calories?
If you think you are drinking alcohol for health, stop now. If you’re drinking it for pleasure, keep your intake moderate and don’t worry about the form, as long as it’s not — for example — paint thinner. If your question is about calories, spirits are the most efficient alcohol in terms of bang for buck; beer is the least. Of course if you take your spirits with ginger ale, it’s a different story.

What about the theory that red wine is good for you?
The antioxidants from the skins of grapes may confer unique health benefits, which would suggest red wine is the best form of alcohol. Again, don’t drink because you think it’s the healthy thing to do.

What about coffee? Please don’t take away my coffee! Caffeine has positive effects, right?
Positive and negative.

What are the positive effects?
Positive: alertness, slightly enhanced cognition.

I’m going to regret asking this but — what are the negative effects?
Negative: potential increases in heart rate, blood pressure, jitteriness, and insomnia.

Not cancer?
No.

I love lattes, but which milk should I use? Are nut milks just flavored water?
No. But nut milks aren’t nutritional powerhouses, either. (Of course, like dairy milk, many such products are nutrient fortified.)

What about oat milk? How do you milk an oat?
Oat milk is made by soaking oats in water, then grinding and straining.

So that is basically oat-flavored water?
Well, with some of the nutrients featured in oats.

Do I need to drink milk at all?
Only if you were born yesterday. Literally.

I thought I needed the calcium. How much calcium does an adult need?
How much calcium we need to eat daily varies with factors such as our activity level, dietary pattern, protein intake, acid load (from foods and medications), life stage (e.g., pregnancy, lactation, senescence), and so on. The closest thing to a one-size-fits-all amount is: roughly 1,000 mg per day.

What are non-dairy sources of calcium?
Kale and other dark leafy greens, beans, soy. Calcium is actually quite widely distributed in the food supply.

But really, in 2018, I’m all about inflammation, which is bad and causes diseases. I’m sure I read that somewhere.
Inflammation is not bad; we need “inflammatory” responses to defend ourselves against germs, and the rogue cells that can cause cancer.

Okay, but it’s sometimes bad. Right?
What is bad is imbalance, and we tend to have an excess of inflammatory exposures and a deficiency of anti-inflammatory exposures. So, for instance, refined carbohydrate and added sugar tend to be inflammatory because they drive up insulin levels and insulin triggers inflammatory responses. We tend to get more saturated and omega-6 fat than we should (from processed foods and many of the oils used in them), and these are inflammatory. Omega-3 fat (from fish, seafood, walnuts, certain seeds) and monounsaturated fat (from olive oil, avocado, nuts and seeds) are anti-inflammatory.

Wait, wait, wait. You lost me at “monounsaturated.” Can you make this simpler?
Water instead of soda: good.

Whole grains instead of refined grains: good.

Nuts, seeds, olive oil, avocado: good.

Fish and seafood in the place of meat: good.

In other words, an “anti-inflammatory” diet is a good diet, one that avoids highly processed foods, lots of meat, lots of full-fat dairy, refined carbs and added sugar, and is instead made up mostly of vegetables, fruits, beans, lentils, whole grains, nuts, seeds, and plain water.

But not seltzer water.
Plain seltzer is fine for generally healthy people, and a far better choice than any of the popular sugary drinks.

Doesn’t seltzer water decalcify your bones?
No.

I’m pretty sure I heard that it does.
It does not.

That’s good, because I like seltzer with a snack. Is snacking okay, or should I stick to three square meals?
There is some evidence suggesting a benefit from smaller meals spaced close together, in terms of total insulin requirements. There is also some evidence that eating earlier in the day is beneficial relative to packing in calories close to bedtime. But these matters are much less important than total daily diet quality, and quantity. Get those right, and almost any timing will be okay, although timing might make a good diet even better. Get quantity and/or quality wrong, and no time is a good time. What you eat matters more than when you eat it.

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