Michelle Routhenstein is a Preventive Cardiology Dietitian, Registered Dietitian Nutritionist, and Certified Diabetes Educator who specializes in heart disease management and prevention. She has a Master of Science Degree in Clinical Nutrition and completed her nutrition dietetic training residency at New York University. She has over 10 years of experience counseling individuals and families on chronic disease prevention and management through personalized, science-based nutrition and lifestyle medicine. She has a thriving nutrition counseling and consulting private practice, in which she sees clients in her New York City office and virtually. To contact Michelle, you can visit her on her website, Entirely Nourished, or on Instagram. She recently published a cookbook called the Truly Easy Heart Healthy Cookbook, which is available on Amazon.
Why does eating healthy matter?
Nutrition goes way beyond weight loss. And it's tied to so many different chronic conditions from cardiovascular disease, cancer, lung disease, and diabetes.
We really want to focus on optimizing the controllable risk factors that have a significant amount of nutrition and lifestyle impact.
Knowing your numbers & evaluating your chronic disease risk
In many cases, your abdominal weight may be even more important than the number on the scale.
I encourage many of my clients to take their waist circumference by using a measuring tape (one that is soft) and line it up to where your belly button is. Just relax your stomach, don't suck in, put it over it very gently and read the number.
Your waist conference should be less than 35 inches for a woman and less than 40 inches for a man. It's not your pants size, it's above your pants size. This gives a really good idea of your chronic disease risk.
A lot of times we'll go to the doctor and they'll take a bunch of blood tests and they'll say everything looks fine, but the ranges are so broad- if you actually look over the results every couple of years, you might see some trends going up.
It's important to know your body mass index (BMI), which is your height-to-weight ratio. You can ask your doctor to explain these things to you; and if they're not, seek a health professional, who will. You should know your hemoglobin A1C, your lipid panel, blood pressure, and thyroid function.
How does fad dieting affect the body?
Fad dieting causes your body to lose weight too quickly (more than one to two pounds a week). This can actually scar your liver tissue and put a lot of stress on your heart.
Many people will lose weight with fad dieting, but once they go back to regular eating, they'll gain the weight back, and sometimes even put more weight than before.
When we have weight fluctuations, that causes our heart rate to increase our blood pressure, leading to a rise in blood sugars and can essentially slow down our metabolism.
When it comes to healthy eating, the number one thing you need to ask yourself is, “Is this sustainable long-term?” Meaning for six months or a year… If not, it's probably not the right diet for you.
This vicious cycle of yo-yo dieting has a lot of detrimental impacts on our metabolic rate and our metabolism, but also on our heart health.
Detox diets are not necessary. If you feed your body the right foods, your body will work the way it's supposed to, to detoxify it on its own.
Having a good bowel movement, urinating frequently, and sweating frequently is all you need for proper detoxification without these extreme diets.
The Keto Diet
The real definition of the Keto diet is 75% fat, 20% protein, and 5% carbs.
Our primary fuel is carbohydrates and that's what fuels our brain and gives our brain the energy it needs. So, when we are having such a deficit of carbs or relying on fats to get broken down into carbohydrates, and this then creates ketosis, which is where the ketogenic diet got its name from ketosis is a survival mechanism.
Our body does not go into it unless it has to, because it needs to burn the fat that we're storing in order to energize and give the fuel to our brain.
The ketogenic diet has also been shown to increase cholesterol levels. I've seen people have cholesterol levels in the seven hundred range after going on the ketogenic diet.
When we look at the research, keto has been shown to help people who have epilepsy or have a lot of seizures. This stops their seizures from happening. But for a general person, this can actually do a lot more harm.
If anyone has tried it, you can attest to the fact that there's that week period called the “keto flu”, where you don't feel well. That's your body not knowing how to process this. And so you're cranky and you're tired; that's your body rejecting it from the start.
Keto also puts a lot of stress on the cardiovascular system and can cause a lot of plaque and cholesterol buildup in the arteries.
How do macro and micronutrients play into eating healthy?
For our body to function properly, you need your carbs for that primary fuel, your protein for muscle repair, and you need healthy fats also for brain health, vascular health, and blood vessel health.
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Carbohydrates & Fiber
For instance, with carbs, you'll want to choose your complex carbs, the carbs that have that fiber.
Your fiber is in beans, legumes, vegetables, and whole grains.
Lean protein can be found in chicken breasts, fish, beans, or low-fat dairy.
Healthy fats include extra virgin olive oil, flax seeds, chia seeds, etc. But the portions are all going to differ based on your needs.
Generally speaking, I like to keep my starchy carbs, like whole grains to about half a cup, and your protein to about four to six ounces, depending on how tall you are and how athletic you are.
For fats, I usually stick to about two teaspoons per meal, because they are more calorically dense, and we don't want to overdo them- this could increase weight gain.
Eating the rainbow
If you can eat the rainbow, that's where you'll get a lot of different nutrients. We definitely want to be strategic with this especially, if you have dietary restrictions.
So for instance, someone who's vegan would need to supplement with B12 because that's only found in animal products and they might have to be supplementing also with omega-3.
How do I know if I'm eating the right amount?
Food is enjoyable, which is why I don't encourage counting calories. However, a great way to scale yourself is through the hunger scale.
One is you're starving- you'll eat anything in sight. And 10 is you ate so much, you feel overstuffed.
You never want to be on any side of the spectrum because when you're starving your body can't satiate itself.
With 10, you are at an increased metabolic load and when you have too much to eat, you're now forcing your body to process the carbs and the fats, and the protein- and it just can't process all of that at one time. You want to be between a 4 and a 6.
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Tips for eating healthy on a budget
Plan your meals
Look through your pantry and your fridge and freezer to see what you already have and then only purchase what you're planning to use.
Going to the grocery store with a grocery list and a plan is super important.
You also want to leave room- for example, you don't necessarily need to add “asparagus” to the list, but maybe you just write “vegetables” on your grocery list.
This way you can look to see which vegetables are cheaper or are on sale at the grocery store. A lot of times seasonal foods will be cheaper and they also will contain more nutrients because if they're seasonal, they're more local.
Make home-cooked meals
Assessing where you are now and see if you cook more at home you will also save more money, but you need to plan the meals and buy the appropriate groceries to cook what you planned.
I like to shop a lot of frozen fruits, vegetables, and protein, especially fish as much more economical if you buy it in the freezer aisle and it's fresher.
Frozen fruits and vegetables are picked at the time of ripeness and are then frozen. So they actually retain all of their nutrients.
Buy in bulk
If you like certain grains or nuts, buy them in bulk. They're usually cheaper than if you buy them in single portions because you're paying for that extra pack packaging.
Try more meatless meals that include beans, soy, etc., as they are much cheaper than animal protein.
If you're making something, try to double or triple the recipe. You already have the ingredients and you don't want to waste that extra food- use all that you have!
Save the rest in your fridge or freeze it for another time so that you can just easily pop it out.