What’s the Best Diet?

By Dr. Emilia Ripoll, M.D.

Patients frequently ask me, “What’s the best diet?”

I tell them that’s a hard question to answer because everybody’s body is different. One person might do really well on a particular diet, and that same diet causes all sorts of problems for someone else.

What I can say for sure is that the word “diet” is a misnomer. If you are “dieting” to lose weight, when you lose the weight, you’ll probably go off the diet, and the weight will most likely return. This kind of yo-yo dieting will drive you insane in the long run, cripple your self-esteem, and wreak havoc on your metabolism.

The only way to lose weight and keep it off permanently is to change your lifestyle — including your relationship with food (the types of food you eat), your exercise habits, and your stress level.

In addition, your interactions with other people also matter. For example, if you routinely enjoy the company of family, friends, or co-workers, you are less likely to feel stressed out about your finances, your kids,  your love life, and so on.  You’re also less apt to be lounging on the couch late at night watching TV reruns, and mindlessly grazing on your favorite comfort food.

The best lifestyle advice I can offer is this: When all else fails, take simple carbs off your plate.

Regardless which diet plan you adopt, if you want to be healthy, it’s critical to stop consuming sweeteners (in foods and beverages), stop eating fast food (yes, that includes pizza), and give up processed foods altogether (the “food” in those bags and boxes is killing people).

According to Gary Taubes, author of Why We Get Fat: And What To Do About It, the consumption of refined carbohydrate is inescapably linked to “Western diseases” (cancer, heart disease, stroke, diabetes, obesity, Alzheimer’s, hypertension, periodontal disease, and others).

“These diseases and conditions are common in societies that eat Western diets and live modern lifestyles, and they’re uncommon, if not nonexistent, in societies that don’t… Colon cancer is ten times more common in rural Connecticut than Nigeria. Alzheimer’s disease is far more common among Japanese Americans than among Japanese living in Japan; it’s twice as common among African American as among rural Africans.”

Taubes goes on to point out that when indigenous people (Native Americans, Inuit, Maasai, Kikuyu, and people from several South Pacific Islands) were introduced to flour and sugar — Western diseases (cancer, heart disease, and so on) followed.

I also cannot overstress the importance of eating several helpings of fresh vegetables (preferably organic) every day. The majority of vegetables and fruits are excellent sources of phytochemicals that fight cancer, antioxidants that inhibit the formation of disease-causing free radicals, fiber that aids digestion, and very low-glycemic carbs that produce a gradual rise in blood sugar.

In my experience, a low-glycemic diet is the most successful lifelong diet plan. The Paleo Diet and the Okinawan Diet are excellent examples of low-glycemic diets because they provide your body with all the necessary macro- and micro-nutrients without bogging it down with inflammatory foods that erase all the good work you’re doing to keep your body fit and healthy.

A low-glycemic diet is different from most “diets” because it focuses on food types rather than counting calories (although calories are still important). The words “low glycemic” refer to carbohydrates that are metabolized slowly and do not produce a spike in insulin, which is a pro-inflammatory hormone that increases inflammation on both the cellular and systemic levels. Insulin also stimulates the liver to produce fat. In general, the lower you eat on the glycemic index (GI) the better. For example, an apple has a glycemic index of 40 (low), but watermelon is 72 (high); oatmeal has a GI of 55 (medium), while Cornflakes™ are 93 (high); and carrots have a GI of 35 (low), but a baked potato is 111 (very high).

The skinny on insulin is that if your body is releasing it into your blood stream, you’re not burning fat. If you want to burn fat (i.e. lose weight), it is crucial to restrict your intake of carbohydrates, which stimulate the production of insulin. Notice that I didn’t say eliminate carbohydrates. Carbohydrate restriction takes some getting used to — especially if carbs have been a big part of your diet. The idea of limiting our carbohydrate intake also goes against all the low-fat misinformation we’ve been fed by well-intended sources for decades. Many people think, “Oh my God. If I don’t eat carbs, what am I going to eat?” The answer is lots of vegetables (themselves a very low-glycemic, high-fiber, high-water content carbohydrate); a moderate amount of protein (a cigarette-pack size portion per day is fine for most people); and high-quality fats like olive oil, coconut oil, avocados, and nuts.

Perhaps the most interesting thing about not eating carbs is losing that feeling of being full and still looking to satisfy the craving for something sweet like ice cream or brownies. The curious paradox about eating a low-carb diet is that you will probably take in more calories than before — and lose weight.

Perhaps this paradox really isn’t one at all, as Dr. Loren Cordain, Ph.D. explains in his book, The Paleo Diet: Syndrome X diseases (type 2 diabetes; heart disease; hypertension; high levels of fat in the blood; obesity; polycystic ovary syndrome; myopia; acne; as well as cancer of the breast, prostate, and colon) are all linked to high levels of insulin in the bloodstream. In other words, the insulin your body secretes after eating sweet, starchy carbohydrates causes all sorts of problems and makes you fat.

Plant-based, whole-food diets like the Okinawa Diet or the Paleo Diet nourish the body without producing a pulse of insulin after every meal. The proof that these diets work is in their longevity.

For example, Okinawan elders are the longest-lived and healthiest seniors in the world. When Okinawan people stray from their traditional diet or move to another part of the world, their life spans and health soon becomes similar to those of the dominant culture (or food culture) around them.

The Paleo Diet is based on how humans ate for 2.5 million years — before the agricultural revolution (approximately 15,000 years ago) shifted us from hunter/gathers to grain eaters. The Paleo Diet is comprised of approximately 65-80 percent vegetables (which alkalizes your body), a small amount of seasonal fruit, and the rest is lean protein and healthy fats.

I also cannot say enough about selecting animal products that are free of all the hormones, antibiotics, and other chemical junk used in conventional agriculture. I highly recommend that you select meat that is grass fed, hormone-free, antibiotic free — preferably wild (fish) or organic if you can afford it. (In general, sheep, graze on pasture land and are not raised in feed lots; therefore, their meat is free of hormones and antibiotics.)

In addition, I strongly discourage my clients from eating genetically modified organisms (GMOs) of any sort. Crops that are genetically modified to resist a particular herbicide (glyphosate) are not part of a healthy diet because we simply do not have any long-term data about the affect of this type food on people; likewise, genetic material from a flounder and blue-green algae have no business being in a tomato. In the natural world, such genetic combinations would be impossible. Who would want to eat a tomato that’s part fish?

Also, I advise men and pre-menopausal women to avoid eating soy in any form: soy milk, tofu, tempeh, edamame, and so on. Why? The primary reason is that soy is full of phytoestrogens, which mimic estrogen in the body. Men need to eat estrogen-rich foods the way Superman needs kryptonite. High levels of estrogen are also linked to breast cancer, which is a great reason for women to avoid soy. The second reason to avoid soy is that 91 percent of soy grown in the United States is GMO. Finally, soy blocks pancreatic enzymes, which not only help digest our food but destroy cancer cells as well. When you combine phytoestrogens with genetically modified food and a compromised immune system, the result is a gastronomical time bomb.

Because almost everyone in the United States cooks their meat (When was the last time you eat steak “tartar”?), we denature all the fats and proteins in the meat. So most people also need to supplement their diet with small amounts of high-quality oils (a perfect oil combo is equal parts butter and olive oil) and a protein shake now and then.

When my patients argue that whole grains are part of a healthy diet, I tell them that our insulin system was not designed to be our primary fuel mechanism; fats were. Think about it this way, the human body is like a flex-fuel car: It can run on several fuel sources.  If you train your body to burn carbs for energy, you’ll burn carbs for energy. If you train your body to burn fat for energy, you’ll burn fat. When your body burns fat, there’s no insulin response because insulin is only involved in sugar metabolism. On a moderate diet of healthy fats, proteins, and vegetables, there’s little-to-no weight gain and much lower incidence of major disease (cancer, heart disease, diabetes, and so on).

Scientists estimate that Paleolithic man ate only 27 teaspoons of sugar per year — hardly using insulin at all. As of 2010, the average American was consuming 11.9 teaspoons of sugar per day (43.5 pounds per year). That’s obscene! By eating so much sugar, we are consuming counter to nature and asking our poor pancreas to make up the difference — which is a recipe for disaster.

The take-home message is simple: Change the types of food you eat, change your life.

Here are five simple lifestyle tips that will have an immediate impact on your health:

  1. Avoid sweeteners (white sugar, brown sugar, honey, agave, maple syrup, high fructose corn syrup, turbinado, even low-calorie sweeteners like aspartame). Stevia is acceptable because it contains zero calories and no sugar; however, the body still produces small amounts insulin whenever the “sweet” receptors of the tongue are stimulated. Even with stevia or aspartame, the body prepares itself for a dose of sugar that never comes — so a small pulse of insulin goes into the blood stream, which contributes to insulin insensitivity, cellular and systemic inflammation, and the body storing more fat than it burns.
  2. Experiment with slowly eliminating carbohydrates from your diet. No carbs means no insulin in your bloodstream, which has an amazingly healing impact on your body. I realize that this suggestion is a big shift for most people, especially athletes, and I do NOT suggest going off carbs “cold turkey.” It takes several weeks for you body to shift over from carbohydrate metabolism to fat metabolism, and there is a real science to replacing carbs with healthy fats and protein. After the initial break-in period, however, your food cravings go away — and even though your calorie consumption goes up — your weight will go down.
  3. If restricting your intake of carbohydrates feels like a daunting task, try taking a vacation from fast foods and processed foods. Replace these non-foods with vegetables, healthy fats, lean protein, and fruit. Take this holiday for a week and see if you body feels different.
  4. Move your body every day for at least 40 minutes. Exercise reduces stress, decreases cortisol levels (which allows your body to burn fat better), and increases insulin sensitivity (so you metabolize carbohydrates better). Research shows that the only group of people who lose weight and keep it off permanently are the ones who get 40 minutes of aerobic exercise at least six days a week. It doesn’t matter what kind of exercise you get as long as you are breaking a sweat and pushing your heart rate. It’s important to realize that the “calories-out” portion of exercise is not what makes most people lose weight. It is, however, what keeps them feeling happy, stable, and sane (instead of reaching for a doughnut) as they go through the ups-and-downs of life.
  5. Consider this: Humans are the only species on this planet that consumes milk after they have been weaned from their mothers. We are also the only species that drinks the milk of another species (cows). Our bodies weren’t designed to do that. Can you imagine a pack of early humans trying to tackle a buffalo so they could get a drink? Try giving up dairy for a week and see how your body feels. Chances are you’ll discover that you feel lighter and have fewer allergic reactions.