Dr. Harshit Shah is an endocrinologist with Dignity Health Medical Group in Bakersfield and is passionate about advising patients on the best diets to manage conditions like diabetes.
Based on the evidence, I recommend a whole food, plant-based diet, which is low in fat, and high in minimally processed and whole foods, for a healthy living. These days, nutrition labels and food labels can be very confusing, so I'd like to share some tips!
1. Focus on Foods Without Labels
It is a great goal to try to only eat foods that do not require labels. You want your refrigerator and pantry to be full of fruits, vegetables, whole grains, healthy nuts, and legumes. Most of these items can be purchased without packaging (unless the package just functions to hold single ingredient like beans), which is another plus!
2. Don't Believe Company Claims
Although it is enticing, do not believe everything you read on the front of a food package. Be wary of deceptive marketing techniques that try to make unhealthy food appear healthy. Words like "natural" and "wholesome" don't always mean the food is healthy for you.
Also, beware of labels that include statements on the front with wording like “excellent source,” “good source,” or “ helps build bones,” because these are not reviewed by the FDA.
Remember to use common sense. A packet of potato chips with 25 percent less sodium is still unhealthy and will still have high levels of sodium! Similarly, low-fat versions may have unwanted ingredients which are unhealthy.
3. Check the Ingredient List
Do not fall for false promises that flour is from whole grains unless it says 100 percent whole wheat or 100 percent whole grain on the packaging. Processed flour can be listed in many ways like "wheat flour" or "enriched wheat flour," or "unbleached flour." Those phrases don't mean the flour is whole grain.
Remember that ingredients are listed in descending volume order. So, if you see a long list of words ending in “ose” — like glucose, high fructose corn syrup, or maltose — that means there are multiple sources of added sugar in that food item! It's okay to have a small amount of added sweeteners in your food, but if you're trying to be healthy, it should not be the main ingredient.
4. Check the Nutrition Facts Label
The following image is from the FDA, which shares information about the new nutrition panel. You'll want to look specifically for the following things.
Look at the serving size and the total servings in a package. Then ask yourself, “How many servings am I consuming?” Serving size in the new label reflects how much people typically eat at one time. You can actually ignore "% DV" which means percent daily value. This number is not applicable to all people and is based on research from 1968.
You should look for foods that have zero or extremely low trans fat, cholesterol, and saturated fat. Plant foods do not have cholesterol, so if you see an amount listed for cholesterol it's a clue to re-read the ingredient list and look for hidden animal products.
Generally, individuals should look for foods that have less than 3g of fat per serving. I typically don't recommend calorie counting, but if you want to count calories, make sure your fat intake is no more than 10 percent of your total calories.
Figuring out the percentage of calories from fat requires math, but it will become easier once you get the hang of it! Remember, we are looking for 10 percent of the total calories, not the % DV. For example, in the nutrition label above, the total calories in a serving is 230, and the total fat is 8g. Keep in mind that 1g fat is equal to 9 calories (Kcal) of energy.
Let's do the math...
Ten percent of 230 calories
10% of 230 = 23
8 (grams of total fat) times 9 (number of Kcals per gram of fat)
8x9 = 72
In the example food label above, the calories from fat should not exceed 23 calories, and this food has 72 calories from fat so it is too high.
The amount of added sugar listed on the food label includes sugars that are either added during the processing of foods, the sugars from syrups and honey, sugars from concentrated fruit, or vegetable juices. For added sugars, you should aim to have the % DV be 5 percent or less.
Fiber is one nutrient you should get more of! If you are on a whole food, plant-based diet, you don't need to worry about your fiber intake. Otherwise, follow the "5:1 Fiber Rule." This means that your total grams of carbs per total grams of fiber should be at 5 or below.
For example, the total carbs in the label above is 37g and fiber is 4g. The ratio is 37/4 = 9.25, which is well above 5, so you should put this food back on the shelf!
Despite what you may hear, plant-based diets are healthy, safe, and have lots of great options for protein, like legumes, whole grains, and nuts. These days, there is a lot of stress put on protein intake, although studies show that we eat way more than the recommended intake of 42g of protein per day. Honestly, I tell my patients to focus on getting more fiber, which is only found in plant foods.
The USDA has set a recommended high of 2300mg of sodium or salt per day. I actually recommend my patients aim for 1500mg or less each day. You've got to be careful because added salt is present in most packaged foods at very high levels, and the % DV number is not helpful.
A simple rule to follow is to try to keep your sodium to calorie ratio at less than 1:1. So if a food is 100 calories, it should not exceed 100mg of sodium per serving. For condiment foods that you don't consume much of, this ratio should be below 4:1.
If you have questions about what diet is right for you, talk with your doctor!
Dr. Harshit Shah, endocrinologist with Dignity Health Medical Group in Bakersfield, is currently accepting new patients. Click here to learn more or make an appointment.
Resources: FDA, Forks Over Knives, PlantPlate, NutritionFacts, JeffNovick.com