Nutrition's impact on overall health from a doctor's perspective
RestoreHealth nutrition

Nutrition's impact on overall health from a doctor's perspective

Michelle Schwartz

By Catherine Collings, MD, MS, FACC, DipABLM

Most of us implicitly understand that nutrition impacts overall health.  We have only to look within our own family, friends, or communities to find many people who have regularly consumed convenience or ultra-processed foods as their main source of nourishment and go on to acquire diabetes, obesity, or heart disease.  But do we really understand the full impact of what we do and do not eat and the risks of chronic disease and mortality?  Just how important is nutrition compared to other factors in our lives?

The State of US Health 1990-2019  

Reported by The US Burden of Disease Collaborators in the updated US State of Health Report, diet led as the top risk factor for death and disability amongst Americans.  And in a companion analysis globally, the results were similar.

Global Burden of Disease Study

The health effects of dietary risks were also studied in 195 countries between 1990 and 2017 showing that diet risks were responsible for more deaths globally than any other risk factor, including tobacco smoking.  More than 50% of the diet-related deaths were related to insufficient intake of whole grains, fruit, and sodium.

Clinical Practice Guidelines and Dietary Guidelines for Americans

Clinical practice guidelines help clinicians in their patient care.  More and more guidelines include dietary recommendations, recognizing that higher quality diets are associated with lower risk of major chronic diseases.  Furthermore, adherence to food based dietary guidelines such as the Dietary Guidelines for Americans has been shown to improve quality of life, mental health, healthy weight, and lower risk of chronic diseases such as heart disease, diabetes, and cancers, as well as all cause mortality.

The evidence is clear and comprehensive.  Yet why is there seemingly so much confusion about nutrition and which is diet is the best?

Since the rise of the food industry and the internet, there have been debates about the relative virtues of macronutrients in the diet and types of diets.  Dietary labels aim to inform the merits of packaged products but fall short on reporting the vast variety of micronutrients and bioactive compounds in foods that also underlie their health outcomes. After all, we don’t eat macro or micronutrients. We eat food.

Where the confusion ends

Fortunately, we now see a great deal of agreement in what optimal nutrition is, and this can increase clinicians’ and the general public’s confidence.  In a meta-epidemiological study of food-based dietary recommendations and clinical practice guidelines between 2010 and 2021, there is substantial consensus for adults to consume fruits, vegetables, legumes/pulses, and whole grains while limiting intake of salt or sodium and alcohol.  Neither extreme macronutrient diets nor popular diet trends were supported by the study results.

When it comes to cardiovascular disease which remains the number one cause of death worldwide and to diabetes and obesity which have both risen over the past 3 decades, there was also consensus. Clinical practice guidelines for major chronic conditions endorse consumption of major plant food groups and guidelines for cardiovascular disease and diabetes align with additional messaging to consume legumes/pulses, nuts and seeds, and low-fat dairy.  

What are RestoreHealth’s nutrition recommendations and messaging?

At HealthFleet, we understand the importance of the latest studies for improved health outcomes. Our RestoreHealth program follows nutritional recommendations and messaging centered on balanced eating patterns and health-promoting eating habits rather than a specific diet. In keeping with evidence-based clinical practice guidelines and dietary guidelines, we encourage whole foods with a focus on a wide array of vegetables and fruits, lean animal and plant protein, healthy fats, and fiber-filled carbohydrates while discouraging ultra-processed foods, sweets and added sugars, unhealthy fats, and excessive salt or sodium, and alcohol.  Additionally, we teach our members how to practice mindful and intuitive eating habits to help them create their own eating pattern that is individualized and health-promoting. This pattern of eating most closely resembles a Mediterranean diet but is easily adapted to members with specific dietary preferences or clinically directed needs.  Our results show that members sustain improvements in weight, diabetes, lipid, and blood pressure values.

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