You Are What and How You Eat
/“Garbage in, garbage out.”
You are what you eat. I do not think there is a person alive who doesn’t know that phrase. But really, it should read: you are what and HOW you eat. The ‘what’ is important, the ‘how’ is perhaps even more so. I see a lot of patients whose basic complaints boil down to “I just don’t feel well”. Achy, tired, can’t sleep at night, yet fall asleep all day, a vague list of intestinal complaints. Feeling more and more anxious, maybe a little depressed. Sound like you?
Let’s start by stating that there are certain “Laws of the Universe”. Yes, we are all individuals, life is what we make it, we have different needs at different times in our lives. But when it comes to physical bodies, certain rules apply to us all. We need to sleep, eat, hydrate, eliminate and exercise to thrive. We need to find love and purpose in life, that is our true fuel. This essay does not address the latter, I’ll save that for further discussions. Here we will stick to the mundane: lifestyle choices.
I see so many people come into medical clinics complaining about not feeling well. Again, nebulous complaints of being exhausted, having joint and muscle pains, headaches, heartburn, and bloating. Could it be fibromyalgia? Or IBS? These diagnoses are very real and pervasive… and also very unsatisfying. People who experience chronic symptoms of discomfort and dysfunction are invariably disappointed to some degree when their labs return normal, the ultrasounds and CT scan show nothing. Patients are often mistrusting of their negative results – “surely, something is wrong with me to feel this way”. I get it. While these symptoms persist with just enough moderation that most people are able to go about their daily lives, the plaguing nature of the given complaint creates worry: what if my doctor is missing something? Patients get sent to specialists, undergo extensive testing and try medications, with often not much improvement.
Allopathic medicine has very clear definitions of what constitutes a given disease. Subjective complaints like achiness, fatigue, light headedness, poor concentration, gas and bloating, chronic constipation or diarrhea are addressed symptomatically in Western medicine clinics but are (usually) not recognized as disease themselves. Patients aren’t being educated about the disease precursors they actually are. It is usually these chronic irritations that hail more serious things to come later on when not properly addressed. It is much easier to maintain your health than to regain it once an actual disease has begun. For many of us it is the impact of disease development that has us looking to make changes and educate ourselves. The foundation of health comes from the things we do (and don’t do) everyday. It is simple daily habits that have the biggest impact on the long term.
A major portion of this is diet and lifestyle. I think a lot of people are sick of hearing that phrase. The world of food has become as complex as our lives. And the wellness industry has everyone in information overload, often with contradictory information. Is gluten bothering me? Should I eat a high carb diet? Or a low carb diet? How much water should I drink? Is dairy bad? And how on earth does anyone find time to exercise? Let alone keep up the information download the internet provides!
Know that most of us are coming from a dysfunctional culture where our entire life rhythm is off. In America the what and how we eat is unhealthy. Our sleep/wake patterns are unnatural. We live to work and rarely, if ever, engage in meaningfully rest. Remember, those Universal Laws we cannot get away from. Here we will focus diet. The fuel we put in ourselves every day is core to building a healthy highly functioning, youthful body. The timing of our fueling is what revs the engine. Basically, the right food, eaten at the right time in the right frame of mind is everything. Here is the break down:
1. How to Eat
Before getting into the world of food, a few words on how to eat. As I said, this really may be the most important aspect of diet in general.
First and foremost, never over eat. Never. Not on Thanksgiving or Christmas or your birthday, not ever. It is the singularly worse thing to do to your body. Ok, yes, a very occasionally indiscretion (like on Christmas, or your birthday), will just be a blip in the system. But regular over eating is disastrous for your gut and is the cause of so many dysfunctions, even outside of gastrointestinal complaints.
The other side of that same coin is never eat when you are not truly hungry. True hunger is when there has been at least several hours between meals, when you burp and you cannot taste food. Think of a scale of 0 to 10. Zero is hunger most Americans do not know. It would be if you had not eaten all day, or perhaps longer, dead empty. A 10 is when you have annihilated yourself on Thanksgiving and you think if you vomit you would feel better (most of us know a 10!). You should eat somewhere in the 3-4 range, true hunger, but if you had to you could wait another 30 minutes. You should stop somewhere around 7.5. That’s pretty exact. In other words about 75% full. Your stomach needs some air space to move and secrete properly. When we fill ourselves to the esophageal sphincter we create conditions of bloating, constipation and reflux and that feeling of wanting to fall asleep 30-60 minutes later. Pigging out creates a host of issues, you may be eating the right foods but way too much. Can you get fat on a vegan diet? You betcha.
Another thing I see a lot, especially in office settings where we sit all day, is grazing. It is tantamount to overeating, but does something slightly different. The human stomach is designed to receive a bolus (packet) of food over about a 30 minute period, process it and send it on its way. As peristalsis occurs it churns and homogenizes the food in the stomach, secreting different ratios of enzymes and acid as it goes. This generally takes about 2-4 hours to completely empty the stomach, perhaps much longer if you have eaten something monstrously heavy like steak dinner chased with beer and followed by cheese cake. When we graze, i.e. snacking all day, we upset the stomach’s basic process and generate dysfunction on a mechanical and chemical level.
Another diet faux pas made by many is attempts at daily deprivation. My folks who desperately want to loose weight, I am looking at you. This commitment to drop pounds manifests in eating that 100 calorie breakfast bar in the morning with zero fat creamer in your coffee and a salad for lunch with vinaigrette. A handful of almonds around that 3 o’clock snacky time…. and then you go home. And in the sanctuary of privacy you succumb to the trauma of all that you denied yourself all day. Suddenly, there is the pizza, Chinese food and ice cream, etc - the stuff you battled against. Or just dinner, but way too much of it. And then late night snacks. Folks, food is love. It is the first real love someone bestowed on you right around the first moments of your life. If your parents were crap, someone still fed you, and that connection to food was established. We need to feed ourselves, well and completely every day. We need to love ourselves now, not 40 lbs less from now.
Additionally, we should never eat when we are upset. The chemical milieu that our bodies get washed in when we are stressed, sad or angry modifies what happens to our food. A cheeseburger eaten in joy and gratitude will nourish you more deeply than a hummus plate eaten anxiously.
We talked about how much to eat. But there is a distinct rhythm in which we should do so as well. Digestion, like all other physiologic processes, wakes up and goes to sleep with the rest of your body. So, that means in the morning your metabolism is low, or weak. This translates to the fact that you may not be hungry in the morning, and therefore should not eat. Of course there are caveats to that, as to all of this really. For instance, when I was studying biology in Costa Rica we were getting up at 5 am to go hiking all day. I never ate breakfast prior to this course but you better believe I did then. And lost weight doing so as my baseline activity was so elevated. But in general, breakfast should be light and easy to digest, like cooked grains and fruits. If you imagine your metabolic capacity as a fire, it is very small in the morning, perhaps even just smoldering coal from the night before. Logically, if you had this physical fire before you and you wanted to get it going again you would add some sticks that are dry and easy to burn and build it up from there. Eating bacon and eggs with cheese and pancakes with syrup, sausage, sugary creamy coffee, cold milk and fried potatoes with ketchup is tantamount to throwing a thick wet log on this little fire. Not only is this food wet and heavy, its rather nutrient sparse. This overload of poor quality food creates a severe dampening of your metabolism, and yet also drives the reflex of inappropriate hunger for the rest of the day. This is partly what generates sugar cravings. Another way to look at your metabolic cycle is this: our bodies are of the physical world, which means they are attuned to its rhythm. Sounds goofy and new agey, but it is true. We have known this for thousands of years. Your metabolism wakes up in the morning, and rises with the day and goes to bed around sunset. That means your metabolic peak ability is highest when the sun is highest in the sky. Which translates to lunch being the biggest and heaviest meal of the day. Now I am not giving anyone permission to go indulge in pepperoni pizza, but if you want to eat meat or dairy, this would be the time to do so. EAT. Eat lunch, get yourself satisfied with good wholesome food.
Now, the way you eat in the evening is crucially important. Your metabolism is naturally dying down and needs to be put to bed. Your liver needs time and space to process everything it encountered today. So eating early and light and going to bed with a rather empty stomach will accomplish this. And you will wake up feeling like a million bucks. This is how to address morning fog, achy joints and stiff body, and morning headaches. You will naturally loose weight. If you are eating whole grains, reasonable amounts of good fats, vegetables and minimal animal products without any sugar sprinkled on top, AND you eat to that 75% place waiting until you are truly hungry to do so, I promise you, you will not need to count calories, carbs etc. WHAT? I am serious. This is how we were made to eat.
It bears stating that in addition to a daily rhythm of timing food and not stuffing ourselves that we also need to eat slowly and mindfully. What does that look like? Firstly, no screens in your face. Its surprising how awkward that has become to the modern person, to just sit and eat. No distractions; how many times have you sat in front of a computer or scrolled through your phone only to look down and your food was gone and it surprised you? We need to sit quietly, in a pleasant and calm environment and eat slowly, really chewing our meal. After years of medical training I can bolt food down whole. All while answering phone calls, signing paperwork and charting on the computer. I was amazing, and totally dysfunctional. It is essential to generate calm and enjoyment at meals. Like many tables, our kitchen table ends up being an extension of household desks. I discovered that a pleasant table is crucial to my happy digestion is having a pleasant table. At minimum it gets mostly cleared with perhaps a neat stack at a corner, with all other items on the table neatly arranged. Maybe some flowers, a candle. Giving myself permission to harass my husband and the kids to clear off the junk prior to eating has truly changed the way I digest meals. The emotional visual’climate is which you take in nourishment is essential to sealing in the “how” of eating.
2. What to Eat
This may be better stated what NOT to eat…. I’ll get to that. But first, what is food? What is all of what we eat? Answer: it is everything you come into contact with in your environment. Everything you encounter you eat in one way or another. Food, pollutants, cosmetics including lotions and soaps, thoughts and emotions, internet content - basically all daily experiences – are consumed by your body and mind and must be digested and assimilated. That quart of ice cream at 10:30 pm ends up around your waist, bogging down your guts and clogging your arteries. So too does the content of hours of internet scrolling, fights with your partner and unprocessed grief from your childhood. Just when you thought food choices in 2019 were complicated, now we have added your internal struggles to the menu.
So let’s start with actual food. Nourishment in the form of calories is a great metaphor for how to approach the rest of what you take in. In the Ayurvedic world there are dietary recommendations made for the individual based on Doshic constitution (click this link to learn more about doshas: https://www.banyanbotanicals.com/info/ayurvedic-living/learning-ayurveda/vata-pitta-and-kapha/). But really, it is up to you to decide what you should and should not eat. One universal rule is that food requirements change seasonally. Especially if you live in a four season sort of place. Heavier foods get eaten in cold months, lighter food in hot months. While understanding yourself through your familiar genetic inheritance (like everyone in your family tends to be overweight and develop diabetes and hypertension) or by way of doshic definition (which basically gives you a similar set of information) is very helpful, its not the most necessary thing. We get caught up in trying to find rules for ourselves and it becomes overwhelming. Being overwhelmed usually generates a sense of hopelessness. Also, the rules change all the time for all of us. We may get sick in the middle of the summer or have anxiety in the middle of the winter and what we were eating last week does not work this week. So, when someone asks me if they can eat X my response generally is, “I don’t know, can you?”. This is where mindful eating comes into play. After you eat something, pay attention to how you feel 30 minutes after, 2 hours after, etc. Are you feeling well and energetic or do you want to fall asleep on your face and are achy? Does heart burn ensue or did you get bloated? Are you walking around with gut disturbances all the time? Then something is not right, whether its food choices or habits (as detailed above), or both. I am not trying to be evasive by brushing the question off, but really no one can tell you what you should eat but you. Regardless, here are some general rules to follow:
Eat seasonally. Eat as much local, organic food as possible. Whole food. We in primary care talk about shopping the perimeter of the grocery store. What is sold up against the walls are fruits and vegetables, whole meats and dairy. Obviously you’ll have to go down some isles for grains etc, but generally things in boxes or frozen bags serve no one. Shop your farmer’s market, there is truly nothing healthier and will give you definitive seasonal food choices.
Cook. Remember those universal laws? I am sorry, but you will not achieve your health goals if you don’t cook for yourself. That is perhaps the hardest one for people to overcome. If you do not cook, don’t try to conquer that in a week. Gradually experiment and have fun. Remember I mentioned having a happy biochemical state while you eat? Cooking your own food contributes to this by being creating a deeper relationship with what you eat.
3. Elimination
An essential topic. You have to poop. It seems silly to even bother to say it, except its not. Americans are constipated. Badly. Its so pervasive we don’t even realize it. A predominance of children in this country suffer from health issues directly related to being chronically constipated. Every human being is supposed to defecate daily. I was taught in medical school that this varied and was not necessarily so. Eastern medicine teaches otherwise. Allopathic medicine obtains the view of moving your bowels every other day, or every couple of days as a normal because it statistically is. We have recognized for thousands of years that holding onto stool is literally toxic and is not normal. But so many people do it now it has become the peak of the bell curve. Some people move their bowels more than daily and that is OK. You should not have to strain to have a bowel movement. Nor should you be bloated, gassy, have pain, excess mucus, experience burning or see blood in your stool. The presence of blood ALWAYS warrants a trip to an allopathic doctor, always. Generally you should have a bowel movement upon waking. Going to bed without food in the stomach helps aid in this process. Drinking lots of water and eating high fiber foods (like legumes and vegetables) greatly aid in the proper function of the gut. We have to poop, people. Being free of backed up stool will generate a level an improved level of energy, calm and foster a healthy immune system.
4. Move
Your body was made to move, it is the fountain of youth. Your joints want to be put through their entire range of motion every day. Your heart wants to run fast regularly, every muscle wants to be used. Exercise should, like diet, honor the seasons. I personally jog in the late fall, winter and early spring. I practice more vinyasa styles of yoga in the cooler months. In the hot months I take easy longer walks and attend more hatha style yoga practices. You don’t have to kill it at the gym 5 days a week to be healthy. Ayurveda actually says you should exercise to the point you begin to break a sweat and not past this. There are slight exceptions of course, but exercising to the point of being exhausted is very physically and emotionally draining and can over time do more harm than good. Exercise, like eating, is best received when done in a joyful and calm state. You get far more benefit when you are happy and relaxed. It is to be done in that Goldilocks fashion of not too much and not too little. Death is stillness, immobility, stagnation. If you mimic this behavior on the daily ultimately it is what you will foster for your life as a whole. We have a very luxurious and sedentary culture now. It takes conscious thought to counter balance it.
Practicing the 4 points above will help stoke your fire, called agni in Ayurveda. The term isn’t important, the concepts are. Having an appropriate functioning level of agni is core, it is the first crucial step to changing the direction of derailing bodily functions. When we start to examine what we need to change it can be overwhelming. So many rules! I choose to see all of this information as empowerment. It is not guidelines for deprivation, but liberation. We have all the power in the world over our own lives and the direction they go. Take time to reflect on what needs changing in your own life and choose some small thing that speaks to you to start. We do not have to feel ill. Your life is not only precious but living it to its fullest ability is your purpose.