I have opinions, lots of them. However, when faced with facts, I am not afraid to change my opinions. In fact, I frequently challenge my views by doing a bit of research. I don’t want to hold an opinion based on outdated research.

So with that in mind, I wandered in to one of the most controversial subjects that I know. Not politics, not religion, but diet. Between vegan, gluten-free, Paleo, Keto, and so on, opinions about what we eat can bring blows to the dinner table.

Before I begin stirring the pot, let me start with a ground rule. What you eat is none of my business, and what I eat is none of your business. I believe this blog is fact-based. If you get something out of it, great. If not, there are plenty of other people with opinions with whom you may resonate.

Why I Am Writing About Diet: Fatty Liver Disease

We all know that the number of overweight and under fit Americans is skyrocketing, along with rates of lifestyle-related illness and death. For decades, experts have warned us of increases in heart disease, stroke, blood pressure and more recently, type 2 diabetes. Now fatty liver disease is joining the ranks as a serious threat. If you don’t know much about fatty liver disease, read more about it here.

Fatty liver disease isn’t just a liver disease, any more than the body is just governed by the liver. Research has long proven the relationship between steatosis (liver fat) and other body systems. For instance. we know that the leading cause of mortality in patients with non-alcoholic liver disease (NAFLD) is cardiovascular disease.

An especially compelling article on this subject is, “Relationship Among Fatty Liver, Specific and Multiple‐Site Atherosclerosis, and 10‐Year Framingham Score” by Raluca Pais, et al., appeared in Hepatology in August 2018. Pais and colleagues found that steatosis is associated with carotid and coronary atherosclerosis, as well as cardiovascular mortality risk. In short, the presence of fatty liver appears to be a predictor of cardiovascular mortality. Therefore, if you have fatty liver, you need to be assessed for cardiovascular disease.

Help Is Here

NAFLD and its more severe form, non-alcoholic steatohepatitis (NASH) can be managed by lifestyle changes. Good nutrition, maintaining a healthy weight and regular exercise are essential. 

All this leads me to the age-old question: What is the healthiest diet? This is a tricky question to answer because many people have different goals. For instance, someone who needs to gain weight has different objectives than someone who is trying to lower their cholesterol. However, there are some fundamentals on which experts agree.

Before I delve in to the elements of a healthy diet, I want to mention a few points for consideration:

Don’t trust fad diets, especially if someone is profiting from their claims. Fad diets come and go. Look for diets that are tried and true and have worked for decades or centuries. People eating a Mediterranean diet or adhering to plans like the Seventh Day Adventists follow have very favorable health outcomes.

Enjoy food. Food is more than fuel; it is a chance to enjoy life. Food eaten mindfully is a more pleasurable experience than eating ravenously or mindlessly.

The Healthiest Diet

To find the healthiest diet for me, I looked at what experts agree on. No one is touting eating sugar, especially in excess. The same is true for processed foods and overeating. Most experts recommend keeping sodium on the low side, and generally agree that fiber and vegetables are good for us.

I believe that David Katz, MD got it right. In his research looking at major diets, Katz states, “A diet of minimally processed foods close to nature, predominantly plants, is decisively associated with health promotion and disease prevention and is consistent with the salient components of seemingly distinct dietary approaches.” (Can We Say What Diet Is Best for Health? by Katz and Meller; Annual Review of Public Health March 2014)

Or as Michael Pollan succinctly put it, “Eat food. Mostly plants. Not too much.”

To which I would add, “Sleep enough. Move your body. Enjoy life.”

Further Information

  • Oldways is an organization that applies the principles of the Mediterranean diet to other traditional diets, including African, Asian, Latin American, vegetarian and vegan.
  • True Health Initiative is a growing coalition of over 500 world-renowned health experts, committed to cutting through the noise and educating on only the evidence-based, time-honored and proven pillars of lifestyle as medicine. Check it out!
  • Hepmag.com has some nutrition and fitness tips.